Provider Demographics
NPI:1235429184
Name:STOKES, SIDNEY DAVELL (ATC, CPED,CSCS)
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:DAVELL
Last Name:STOKES
Suffix:
Gender:M
Credentials:ATC, CPED,CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7212 OAKPOINT DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-3978
Mailing Address - Country:US
Mailing Address - Phone:504-453-1832
Mailing Address - Fax:985-649-9118
Practice Address - Street 1:7212 OAKPOINT DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70460-3978
Practice Address - Country:US
Practice Address - Phone:504-453-1832
Practice Address - Fax:985-649-9118
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer