Healthcare Provider Details

I. General information

NPI: 1154437937
Provider Name (Legal Business Name): JONATHAN BRUCE STONE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 S WESTERN AVE STE 102
OKLAHOMA CITY OK
73139-1712
US

IV. Provider business mailing address

6510 S WESTERN AVE STE 102
OKLAHOMA CITY OK
73139-1712
US

V. Phone/Fax

Practice location:
  • Phone: 405-601-5899
  • Fax: 405-601-5903
Mailing address:
  • Phone: 405-601-5899
  • Fax: 405-601-5903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number4871
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2006015423
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: