National Provider Identifier
Jody M Stackman, M.D.
Jody M Stackman, M.D. is listed in the NPPES registry with a primary specialty of Neurology Physician in Ithaca, NY and a listed phone number of (607) 273-6757.
Profile Overview
- NPI
- 1457353666
- Provider Type
- Individual
- Primary Specialty
- Neurology Physician
- Enumeration Date
- June 01, 2005
- Last Updated
- July 25, 2013
Practice Location
- 8 Brentwood Dr
- Suite B
- Ithaca, NY 14850-1871
Phone: (607) 273-6757
Specialties
- Neurology Physician (2084N0400X)
Full Record
- NPI
- 1457353666
- Entity Type
- Individual
- Last Name
- Stackman
- First Name
- Jody
- Middle Name
- M
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 8 Brentwood Dr
- Mailing Address Line 2
- Suite B
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1871
- Mailing Country
- US
- Mailing Phone
- (607) 273-6757
- Mailing Fax
- (607) 273-2854
- Practice Street Address
- 8 Brentwood Dr
- Practice Address Line 2
- Suite B
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1871
- Practice Country
- US
- Practice Phone
- (607) 273-6757
- Practice Fax
- (607) 273-2854
- Enumeration Date
- June 01, 2005
- Last Updated
- July 25, 2013
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Neurology Physician (2084N0400X)
- Other Identifiers
- 00711413 (NY)