Individual
DR. STACY MATTHEW HOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10000 ZANE AVE N, BROOKLYN PARK, MN 55443-1400
(763) 572-5710
(763) 569-6200
Mailing address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
(763) 572-5710
(763) 571-3008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39791
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0114149
MEDICA
MN
01
—
1034895
PREFERRED ONE
MN
01
—
121194
UCARE MN
MN
01
—
1892373
AMERICA'S PPO
MN
01
—
6606626
MEDICA UC
MN
01
—
68F04HO
BCBS OF MN
MN
01
—
7416497
AETNA
MN
05
—
751453100
—
MN
01
—
HP39201
HEALTHPARTNERS
MN
Enumeration date
04/10/2006
Last updated
04/10/2012
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