Provider Demographics
NPI:1154512630
Name:JOHN L STOKER D.O. P.C.
Entity Type:Organization
Organization Name:JOHN L STOKER D.O. P.C.
Other - Org Name:DBA VALLEY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STOKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-733-3660
Mailing Address - Street 1:G5142 MILL ER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507
Mailing Address - Country:US
Mailing Address - Phone:810-733-3660
Mailing Address - Fax:810-720-4777
Practice Address - Street 1:G 5142 MILL ER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507
Practice Address - Country:US
Practice Address - Phone:810-733-3660
Practice Address - Fax:810-720-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007274207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1536560Medicaid
MICL5066OtherPALMETTO GPA
MI0152539665OtherBLUE CROSS
MI1536560Medicaid
MIE26187Medicare UPIN
MICL5066OtherPALMETTO GPA