Provider Demographics
NPI:1700945011
Name:STEPHEN F. BLACKSTOCK M.D., P.C.
Entity type:Organization
Organization Name:STEPHEN F. BLACKSTOCK M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:FEW
Authorized Official - Last Name:BLACKSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-492-2663
Mailing Address - Street 1:300 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1157
Mailing Address - Country:US
Mailing Address - Phone:256-492-2663
Mailing Address - Fax:256-492-8620
Practice Address - Street 1:300 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1157
Practice Address - Country:US
Practice Address - Phone:256-492-2663
Practice Address - Fax:256-492-8620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty