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NPI Code Detail

MEDICARE: DR. DOUGLAS GREEN STOKER D.P.M.

MEDICARE: DR. DOUGLAS GREEN STOKER D.P.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist741023260501UT

General Provider Information

NPI Number : 1548336696
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS GREEN STOKER D.P.M.
Provider Business Mailing Address
First Line : 144 S 700 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1109
Country : US
Telephone Number : 801-532-1822
Fax Number : 801-532-7544
Provider Business Practice Location Address
First Line : 144 S 700 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1109
Country : US
Telephone Number : 801-532-1822
Fax Number : 801-532-7544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 07/08/2007

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