Thomas G Stocks, MD
Individual provider Active NPI Internal Medicine Physician · Spring Park, MN
NPI 1104826064 · NPPES record last updated Mar 11, 2010
Key facts
- NPI
- 1104826064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 29418 (MN)
- Practice address
- 4695 Shoreline Dr
Spring Park, MN 55384-9715 - Phone
- (952) 442-7890
- Fax
- (952) 442-7893
- NPI assigned
- Jul 21, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carlson Chiropractic Health and Healing Inc. | Past |
Accepting new patients | |
| Ridgeview Clinics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 29418 | MN | Yes |
Addresses
Primary practice location
4695 Shoreline Dr
Spring Park, MN 55384-9715
Mailing address
4695 Shoreline Dr
Spring Park, MN 55384-9715
Phone (952) 442-7890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29418 | Other | MN | MEDICAL LICENSE |
| 354285800 | Medicaid | MN |
Other providers in Spring Park, MN
- Sheila N Seats
- Senior Care of Minnesota
- Seniors Care Services LLC
- SP Services
- SP Services
- TCM Wellness Clinic
- Kelly Jean Tibbetts
- Mary Moe Trites
- Aaron Tsay
- Urology Associates, LTD.
All providers in Spring Park, MN · Internal Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.