Healthcare Provider Details
I. General information
NPI: 1770576456
Provider Name (Legal Business Name): VIRGINIA RICHARDS STOKES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/26/2005
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
289 IRELAND AVE BUILDING 851
FORT KNOX KY
40121-5111
US
IV. Provider business mailing address
289 IRELAND AVE BUILDING 851
FORT KNOX KY
40121-5111
US
V. Phone/Fax
- Phone: 502-624-9880
- Fax: 502-624-0481
- Phone: 502-624-9880
- Fax: 502-624-0481
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 22356 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | 22356 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: