Individual
RENNY JOE STOCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5589 GREENWICH RD STE 100, VIRGINIA BEACH, VA 23462-6565
(888) 628-8272
Mailing address
4000 COLISEUM DR STE 200A, HAMPTON, VA 23666-5975
(757) 736-1520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
007239
NY
363A00000X
Physician Assistant
Primary
0110007831
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02499705
—
NY
Enumeration date
05/23/2007
Last updated
12/16/2025
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