Individual
DR. JOHN H STADICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1700 CERRILLOS RD, SANTA FE, NM 87505-3554
(505) 988-9821
Mailing address
1700 CERRILLOS RD, SANTA FE, NM 87505-3554
(505) 946-9219
(505) 983-6243
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
992
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A6452
—
NM
Enumeration date
12/28/2005
Last updated
10/24/2007
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