Provider Demographics
NPI:1154327963
Name:STOKES, JASON R (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:R
Last Name:STOKES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-2449
Mailing Address - Country:US
Mailing Address - Phone:919-553-4111
Mailing Address - Fax:919-553-2845
Practice Address - Street 1:201 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2449
Practice Address - Country:US
Practice Address - Phone:919-553-4111
Practice Address - Fax:919-553-2845
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2852111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890847RMedicaid
NC890847RMedicaid
NC2333247Medicare ID - Type UnspecifiedGROUP NUMBER