Provider Demographics
NPI:1861628141
Name:STOKES, TASHAWNA THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:TASHAWNA
Middle Name:THOMAS
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 1:3745 CHEROKEE ST NW STE 401
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6787
Mailing Address - Country:US
Mailing Address - Phone:770-429-1005
Mailing Address - Fax:770-429-8005
Practice Address - Street 1:3745 CHEROKEE ST NW STE 401
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6787
Practice Address - Country:US
Practice Address - Phone:770-429-1005
Practice Address - Fax:770-429-8005
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101278208000000X
AL30339208000000X
GA68858208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics