Healthcare Provider Details

I. General information

NPI: 1871517888
Provider Name (Legal Business Name): EDDIE M STONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 N 7TH ST
TERRE HAUTE IN
47804-2706
US

IV. Provider business mailing address

7120 N STATE ROAD 135
MORGANTOWN IN
46160-8916
US

V. Phone/Fax

Practice location:
  • Phone: 812-238-7000
  • Fax: 812-238-4508
Mailing address:
  • Phone: 812-597-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01026898A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: