Healthcare Provider Details

I. General information

NPI: 1194241505
Provider Name (Legal Business Name): AARON STOKER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1587 VERNON RD
LAGRANGE GA
30240-4146
US

IV. Provider business mailing address

6226 SEMINARY RD
COLUMBUS GA
31904-2933
US

V. Phone/Fax

Practice location:
  • Phone: 706-884-2655
  • Fax:
Mailing address:
  • Phone: 256-604-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number10404795-9926
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number7499
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN123864
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: