Provider Demographics
NPI:1073541603
Name:STOKES, ROBERT LEE JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
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 1:674 BERKMAR CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1464
Mailing Address - Country:US
Mailing Address - Phone:434-220-7501
Mailing Address - Fax:434-220-9401
Practice Address - Street 1:674 BERKMAR CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1464
Practice Address - Country:US
Practice Address - Phone:434-220-7501
Practice Address - Fax:434-220-9401
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2014-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA137267Medicaid
VA4304203OtherCIGNA
VA59852OtherCOMMUNITY HEALTH
VA010069670Medicaid
VA236702OtherSOUTHERN HEALTH
VAP00450497OtherMEDICARE PIN
VA137267OtherANTHEM SRVS HEALTHKEEPERS
VA8122049OtherMAMSI
VA236702OtherSOUTHERN HEALTH
VA004969W39Medicare PIN