MEDICARE: KENNETH R STOKES MD

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
1	2085R0202X	Diagnostic Radiology Physician	18857	OK
2	2085R0204X	Vascular & Interventional Radiology Physician	18857	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00144991	OTHER	OK	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760485643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH R STOKES MD

Provider Business Mailing Address
First Line	:	5300 N INDEPENDENCE AVE STE 280
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5555
Country	:	US
Telephone Number	:	405-949-3417
Fax Number	:	405-552-5165

Provider Business Practice Location Address
First Line	:	3300 NW EXPRESSWAY FL 2
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4418
Country	:	US
Telephone Number	:	405-949-3417
Fax Number	:	405-552-5165

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	01/30/2019

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Directions to “ KENNETH R STOKES MD” Practice Location

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