MEDICARE: MR. LANNY MICHAEL STONE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA00127	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA00127	OTHER	TX	LICENSE

General Provider Information

NPI Number	:	1487673315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LANNY MICHAEL STONE PA

Provider Business Mailing Address
First Line	:	PO BOX 1219
Second Line	:
City	:	BURNET
State	:	TX
Zip	:	78611-7219
Country	:	US
Telephone Number	:	512-355-9233
Fax Number	:	512-355-9230

Provider Business Practice Location Address
First Line	:	160 N LAMPASAS
Second Line	:
City	:	BERTRAM
State	:	TX
Zip	:	78605
Country	:	US
Telephone Number	:	512-335-9233
Fax Number	:	512-355-9230

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	02/23/2016

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Directions to “ MR. LANNY MICHAEL STONE PA” Practice Location

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