Provider Demographics
NPI:1467673624
Name:PARKVILLE FAMILY PRACTICE, PC
Entity Type:Organization
Organization Name:PARKVILLE FAMILY PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-587-0440
Mailing Address - Street 1:5346 NW 64TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2414
Mailing Address - Country:US
Mailing Address - Phone:816-587-0440
Mailing Address - Fax:816-587-3549
Practice Address - Street 1:5346 NW 64TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-2414
Practice Address - Country:US
Practice Address - Phone:816-587-0440
Practice Address - Fax:816-587-3549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6102261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO5714093CMedicare ID - Type UnspecifiedROBERT L STOKES MEDICARE
MO5710000CMedicare ID - Type UnspecifiedPRACTICE MEDICARE NUMBER
MOC51289Medicare UPIN