Healthcare Provider Details

I. General information

NPI: 1053396812
Provider Name (Legal Business Name): JOSEPH DAVID STOKES JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1193 NORTON AVE SUITE A.
NORTON OH
44203-9516
US

IV. Provider business mailing address

1193 NORTON AVE SUITE A.
NORTON OH
44203-9516
US

V. Phone/Fax

Practice location:
  • Phone: 330-825-0847
  • Fax: 330-825-9569
Mailing address:
  • Phone: 330-825-0847
  • Fax: 330-825-9569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number35055544S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: