Provider Demographics
NPI:1861491136
Name:STOKES, BRENDA L (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:L
Last Name:STOKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 FENWICK DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1701 THOMSON DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1118
Practice Address - Country:US
Practice Address - Phone:434-200-7095
Practice Address - Fax:434-200-6086
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056207207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
700011311OtherCIGNA PROVIDER NUMBER
VA005613906Medicaid
01-02102OtherUNITED HEALTHCARE PROVIDE
216582OtherANTHEM PROVIDER NUMBER
23315OtherMEDCOST PROVIDER NUMBER
VA0056-4236-1Medicaid
249068OtherSOUTHERN HEALTH PROVIDER
31832OtherSENTARA/OPTIMA PROVIDER N
541457983OtherPCHP PROVIDER NUMBER
541457983OtherTRICARE PROVIDER NUMBER
56-1390-6OtherVA PREMIER PROVIDER NUMBE
23315OtherMEDCOST PROVIDER NUMBER
216582OtherANTHEM PROVIDER NUMBER
249068OtherSOUTHERN HEALTH PROVIDER