Individual
DR. ERIC ROBERT STOCKALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2090 JOLLY RD, SUITE 150, OKEMOS, MI 48864-3958
(517) 349-3900
(517) 349-3939
Mailing address
2090 JOLLY RD, SUITE 150, OKEMOS, MI 48864-3958
(517) 349-3900
(517) 349-3939
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301050188
MI
208800000X
Urology Physician
Primary
4301050188
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0330578
BLUE CROSS BLUE SHIELD
MI
01
—
124132
PREFERRED CHOICES
MI
05
—
4172326
—
MI
01
—
C6406
MCARE
MI
Enumeration date
04/27/2006
Last updated
09/20/2018
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