Provider Demographics
NPI:1487876017
Name:STOIKES, NATHANIEL F N (MD)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:F N
Last Name:STOIKES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 UNION AVE
Mailing Address - Street 2:STE 700
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3627
Mailing Address - Country:US
Mailing Address - Phone:901-866-8360
Mailing Address - Fax:901-302-2360
Practice Address - Street 1:6029 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120
Practice Address - Country:US
Practice Address - Phone:901-866-8530
Practice Address - Fax:901-302-2530
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010003271208600000X
TN47375208600000X
ARE-14225208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1487876017Medicaid
AR187448001Medicaid
GA003181851AMedicaid
MS06503076Medicaid
TN103I023903OtherPRIMARY MEDICARE
TN1524156Medicaid
AL177450Medicaid
TNQ018096Medicaid