Provider Demographics
NPI:1588730170
Name:STOCKMAN, GAIL DIANE (MD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:DIANE
Last Name:STOCKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:400 HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-2489
Mailing Address - Country:US
Mailing Address - Phone:903-641-4856
Mailing Address - Fax:903-641-4860
Practice Address - Street 1:400 HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2489
Practice Address - Country:US
Practice Address - Phone:903-641-4856
Practice Address - Fax:903-641-4860
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2013-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT11347207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB26706Medicare UPIN
TX005252Medicare ID - Type Unspecified