Healthcare Provider Details

I. General information

NPI: 1194954859
Provider Name (Legal Business Name): DAVID BRANDON STONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 E RAY RD STE 110
PHOENIX AZ
85044-6094
US

IV. Provider business mailing address

PO BOX 93175
PHOENIX AZ
85070-3175
US

V. Phone/Fax

Practice location:
  • Phone: 480-759-1668
  • Fax: 480-759-1669
Mailing address:
  • Phone: 480-759-1668
  • Fax: 480-759-1669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number47952
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: