Provider Demographics
NPI:1942525704
Name:STOFKO, DOUGLAS LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:LEE
Last Name:STOFKO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:930 E EMERALD AVE
Mailing Address - Street 2:SUITE 511
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4539
Mailing Address - Country:US
Mailing Address - Phone:865-647-3330
Mailing Address - Fax:865-647-3349
Practice Address - Street 1:930 E EMERALD AVE
Practice Address - Street 2:SUITE 511
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4539
Practice Address - Country:US
Practice Address - Phone:865-647-3330
Practice Address - Fax:865-647-3349
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDO2774207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery