Provider Demographics
NPI:1578553210
Name:STOKES, GARY NEIL (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:NEIL
Last Name:STOKES
Suffix:
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 1:655 EAST 1300 NORTH
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341
Mailing Address - Country:US
Mailing Address - Phone:435-792-6500
Mailing Address - Fax:435-792-6608
Practice Address - Street 1:655 EAST 1300 NORTH
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341
Practice Address - Country:US
Practice Address - Phone:435-792-6500
Practice Address - Fax:435-792-6608
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10119882-12052083P0901X
UT0119882-8905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine