Individual
DR. SAM STOKES III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 W JACKSON ST STE 301, CARBONDALE, IL 62901-1474
(618) 351-9300
(618) 351-9307
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
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
Enumeration date
09/27/2006
Last updated
05/25/2023
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