Provider Demographics
NPI:1770576456
Name:STOKES, VIRGINIA RICHARDS (MD)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:RICHARDS
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 1:289 IRELAND AVE
Mailing Address - Street 2:BUILDING 851
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-5111
Mailing Address - Country:US
Mailing Address - Phone:502-624-9880
Mailing Address - Fax:502-624-0481
Practice Address - Street 1:289 IRELAND AVE
Practice Address - Street 2:BUILDING 851
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121-5111
Practice Address - Country:US
Practice Address - Phone:502-624-9880
Practice Address - Fax:502-624-0481
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22356207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5581OtherMEDICAIRE GRP
KY64223563Medicaid
KY1050496OtherPASSPORT
1158101Medicare ID - Type Unspecified
E40956Medicare UPIN
1558101Medicare PIN