Healthcare Provider Details

I. General information

NPI: 1275461105
Provider Name (Legal Business Name): CARLOS STONE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2494 GA HIGHWAY 102
WARTHEN GA
31094-3616
US

IV. Provider business mailing address

2494 GA HIGHWAY 102
WARTHEN GA
31094-3616
US

V. Phone/Fax

Practice location:
  • Phone: 478-232-9032
  • Fax: 478-666-6030
Mailing address:
  • Phone: 478-232-9032
  • Fax: 478-666-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: