Individual
DR. CHARLES TODD STOKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
940 MATTHEW DRIVE, SUITE 2, WAYNESBORO, MS 39367
(601) 671-8555
(601) 671-0777
Mailing address
940 MATTHEW DRIVE, SUITE 2, WAYNESBORO, MS 39367
(601) 671-8555
(601) 671-0777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14421
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00964
AL BCBS
AL
05
—
0113843
—
MS
01
—
279588
TRICARE
—
Enumeration date
10/06/2006
Last updated
07/08/2007
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