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Individual

ELIZABETH STOCKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
2 LIVEWELL DR., THE MEDICAL GROUP DEPT. OF GOODALL HOSPITAL, KENNEBUNK, ME 04043-6762
(207) 985-7174
(207) 985-1304
Mailing address
2 LIVEWELL DR., THE MEDICAL GROUP DEPT. OF GOODALL HOSPITAL, KENNEBUNK, ME 04043-6762
(207) 985-7174
(207) 985-1304

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1588
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
279450099
ME
01
P00110777
MEDICARE RR
ME
Enumeration date
12/19/2005
Last updated
12/29/2011
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