Healthcare Provider Details

I. General information

NPI: 1679553226
Provider Name (Legal Business Name): PATRICK R STOKES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 NORTHWESTERN AVE S
STILLWATER MN
55082-7534
US

IV. Provider business mailing address

1295 BANDANA BLVD N STE 142
SAINT PAUL MN
55108-5115
US

V. Phone/Fax

Practice location:
  • Phone: 651-439-4840
  • Fax: 651-439-4894
Mailing address:
  • Phone: 651-641-7062
  • Fax: 651-641-7195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number217818
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: