Healthcare Provider Details

I. General information

NPI: 1275064115
Provider Name (Legal Business Name): JILL PATRICIA STONE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RM 382 FOOTHILLS HOSPITAL 1403 29 ST NW
CALGARY ALBERTA
T2N2T9
CA

IV. Provider business mailing address

#1108 1540 29ST NW
CALGARY ALBERTA
T2N4M1
CA

V. Phone/Fax

Practice location:
  • Phone: 403-944-4317
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberD0082896
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberD0082896
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: