Individual
KURT T STOCKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5147 N 9TH AVE, STE. 203, PENSACOLA, FL 32504-8771
(850) 476-6110
(850) 479-6042
Mailing address
4205 BELFORT RD, STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6014
(904) 450-6401
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME64368
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009935384
AL MEDICAID
AL
01
—
18969
BCBS
FL
01
—
372995800
MEDICAID
FL
01
—
59101757
BCBS
AL
Enumeration date
02/09/2006
Last updated
01/05/2021
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