Provider Demographics
NPI:1053383265
Name:STOKES, THOMAS JEFFERSON JR (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JEFFERSON
Last Name:STOKES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 VILLAGE PROFESSIONAL DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5442
Mailing Address - Country:US
Mailing Address - Phone:334-749-6523
Mailing Address - Fax:334-742-0242
Practice Address - Street 1:2609 VILLAGE PROFESSIONAL DR
Practice Address - Street 2:SUITE 3
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5442
Practice Address - Country:US
Practice Address - Phone:334-749-6523
Practice Address - Fax:334-742-0242
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9436207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
51019413OtherBCBS OF AL OPELIKA
AL000088821Medicaid
51520920OtherBCBS OF AL AUBURN
51019413OtherBCBS OF AL DADEVILLE
AL0000888818Medicaid
51088818OtherBCBS OF AL TUSKEGEE
AL000020520Medicaid
AL000019413Medicaid
AL000020920Medicaid
51088821OtherBCBS OF AL LANGDALE
51520520OtherBCBS OF AL LAFAYETTE
AL000020920Medicaid