Healthcare Provider Details

I. General information

NPI: 1962755249
Provider Name (Legal Business Name): GEORGE WILLIAM STONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 ROCK MERRITT ST
FORT LIBERTY NC
28310-0004
US

IV. Provider business mailing address

2817 ROCK MERRITT ST
FORT LIBERTY NC
28310-0001
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-8461
  • Fax:
Mailing address:
  • Phone: 910-907-8461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2021-00851
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number2021-00851
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: