Healthcare Provider Details

I. General information

NPI: 1063718807
Provider Name (Legal Business Name): ERNEST W STOKES III PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 W FARIS RD STE 550
GREENVILLE SC
29605-4286
US

IV. Provider business mailing address

890 W FARIS RD STE 550
GREENVILLE SC
29605-4286
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-6800
  • Fax: 864-455-6825
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA-875
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number530
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number10891
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number530
License Number StateSC
# 5
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA59559
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: