Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC006302L | PA |
NPI | 1043382534 |
---|---|
Provider Name | Dr. Gregory P Stokes |
First Address | Riegelsville, PA 18077-0181 |
Second Address | Riegelsville, PA 18077-7005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 16/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0833961000 | PERSONAL CHOICE (01) | PA |
1032053 | ASHN ID# (01) | PA |
23-2827854 | TAX ID# (01) | PA |
369667000 | INDEPENDENCE BLUE (01) | PA |
5214126 | AENTA ID# (01) | PA |
808232 | BLUE SHIELD ID# (01) | PA |
P1121505 | OXFORD ID# (01) | PA |
U60407 | (02) | PA |