Healthcare Provider Details

I. General information

NPI: 1073049474
Provider Name (Legal Business Name): LEA ELIZABETH STOKES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 S MADISON ST
TUPELO MS
38801-6391
US

IV. Provider business mailing address

1041 S MADISON ST
TUPELO MS
38801-6391
US

V. Phone/Fax

Practice location:
  • Phone: 662-844-8754
  • Fax:
Mailing address:
  • Phone: 662-844-8754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number28668
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: