Provider Demographics
NPI:1780867788
Name:STOKES, JIMMIE ROLAND (DC)
Entity Type:Individual
Prefix:MR
First Name:JIMMIE
Middle Name:ROLAND
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 1:1395 CUNNINGHAM RD SW APT 2407
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-7155
Mailing Address - Country:US
Mailing Address - Phone:678-908-7385
Mailing Address - Fax:
Practice Address - Street 1:1395 CUNNINGHAM RD SW APT 2407
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-7155
Practice Address - Country:US
Practice Address - Phone:678-908-7385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008294111N00000X
GACHIRO008294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor