Provider Demographics
NPI:1942496476
Name:STOKES, MAL J
Entity type:Individual
Prefix:
First Name:MAL
Middle Name:J
Last Name:STOKES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72342-0402
Mailing Address - Country:US
Mailing Address - Phone:870-572-3516
Mailing Address - Fax:
Practice Address - Street 1:509 CLEBURNE AVE
Practice Address - Street 2:
Practice Address - City:WEST HELENA
Practice Address - State:AR
Practice Address - Zip Code:72390-3025
Practice Address - Country:US
Practice Address - Phone:870-572-3516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor