Organization
STOKES INSTITUTE OF UROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM STOKES III MD (OWNER)
(618) 351-9300
Entity
Organization
Contact information
Practice address
305 W JACKSON ST, SUITE 400, CARBONDALE, IL 62901-1474
(618) 351-9300
(618) 351-9307
Mailing address
305 W JACKSON ST, SUITE 400, CARBONDALE, IL 62901-1474
(618) 351-9300
(618) 351-9307
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036089297
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089297
—
IL
01
—
03932016
BCBS OF ILLINOIS
IL
01
—
090870
HEALTH ALLIANCE
IL
01
—
632586
HEALTHLINK
IL
01
—
DA7587
RAILROAD MEDICARE GROUP
IL
01
—
G80608
UPIN #
IL
01
—
P00070868
RAILROAD MEDICARE PIN
IL
01
—
P00152699
RAILROAD MEDICARE PIN
IL
01
—
R78376
UPIN #
IL
Enumeration date
07/11/2007
Last updated
01/22/2010
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