Basic Information
| Provider Information | |||||||||
| NPI: | 1487876017 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STOIKES | ||||||||
| FirstName: | NATHANIEL | ||||||||
| MiddleName: | F. N. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1407 UNION AVE | ||||||||
| Address2: | STE 700 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381043627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018668360 | ||||||||
| FaxNumber: | 9013022360 | ||||||||
| Practice Location | |||||||||
| Address1: | 6029 WALNUT GROVE RD | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 38120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018668530 | ||||||||
| FaxNumber: | 9013022530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 06/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2010003271 | MO | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 47375 | TN | Y | Allopathic & Osteopathic Physicians | Surgery | 208600000X | E-14225 | AR | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1487876017 | 05 | MO | MEDICAID | 187448001 | 05 | AR | MEDICAID | 003181851A | 05 | GA | MEDICAID | 06503076 | 05 | MS | MEDICAID | 103I023903 | 01 | TN | PRIMARY MEDICARE | OTHER | 1524156 | 05 | TN | MEDICAID | 177450 | 05 | AL | MEDICAID | Q018096 | 05 | TN | MEDICAID |