Individual
JOHNNY DALE STACKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
910 S DONAHUE DR, AUBURN, AL 36832-2975
(334) 442-4012
Mailing address
910 S DONAHUE DR, AUBURN, AL 36832-2975
(334) 442-4012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO.1476
AL
Other
Enumeration date
05/29/2008
Last updated
07/14/2016
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