Healthcare Provider Details

I. General information

NPI: 1093628331
Provider Name (Legal Business Name): CHARLES CHRISTOPHER STOKES EMT-I
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5717 OLD WAYNESVILLE RD
WAYNESVILLE GA
31566-4421
US

IV. Provider business mailing address

5717 OLD WAYNESVILLE RD
WAYNESVILLE GA
31566-4421
US

V. Phone/Fax

Practice location:
  • Phone: 912-258-2435
  • Fax:
Mailing address:
  • Phone: 912-258-2435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License NumberI044428
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: