Healthcare Provider Details

I. General information

NPI: 1932321924
Provider Name (Legal Business Name): TRAVIS B. STONER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 OSBORNE DR W SUITE 100
HASTINGS NE
68901-9112
US

IV. Provider business mailing address

2207 OSBORNE DR W SUITE 100
HASTINGS NE
68901-9112
US

V. Phone/Fax

Practice location:
  • Phone: 402-462-2139
  • Fax: 402-462-2381
Mailing address:
  • Phone: 402-462-2139
  • Fax: 402-462-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number1228
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number58-001731
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: