National Provider Identifier
Charles L Stackhouse, MD
Charles L Stackhouse, MD is listed in the NPPES registry with a primary specialty of Surgery Physician in Clifton Springs, NY and a listed phone number of (315) 462-2636.
Profile Overview
- NPI
- 1932174497
- Provider Type
- Individual
- Primary Specialty
- Surgery Physician
- Enumeration Date
- February 20, 2006
- Last Updated
- June 13, 2013
Practice Location
- 4 Coulter RD
- Clifton Springs, NY 14432-1122
Phone: (315) 462-2636
Mailing Address
- 4567 Crossroads Park Dr
- Liverpool, NY 13088-3589
Specialties
- Surgery Physician (208600000X)
- Surgery Physician (208600000X)
Full Record
- NPI
- 1932174497
- Entity Type
- Individual
- Last Name
- Stackhouse
- First Name
- Charles
- Middle Name
- L
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 4567 Crossroads Park Dr
- Mailing City
- Liverpool
- Mailing State
- NY
- Mailing ZIP Code
- 13088-3589
- Mailing Country
- US
- Mailing Phone
- (315) 295-2100
- Mailing Fax
- (315) 295-2125
- Practice Street Address
- 4 Coulter RD
- Practice City
- Clifton Springs
- Practice State
- NY
- Practice ZIP Code
- 14432-1122
- Practice Country
- US
- Practice Phone
- (315) 462-2636
- Practice Fax
- (315) 462-2638
- Enumeration Date
- February 20, 2006
- Last Updated
- June 13, 2013
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgery Physician (208600000X), Surgery Physician (208600000X)
- Other Identifiers
- 00835396 (NY)