Healthcare Provider Details

I. General information

NPI: 1265972814
Provider Name (Legal Business Name): HOLMES HOWARD STONER III PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 HARRISON AVE
PANAMA CITY FL
32405-4545
US

IV. Provider business mailing address

3334 CAPITAL MEDICAL BLVD STE 400
TALLAHASSEE FL
32308-4470
US

V. Phone/Fax

Practice location:
  • Phone: 850-877-8174
  • Fax:
Mailing address:
  • Phone: 850-877-8174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1138823
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number026085
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9121711
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: