Healthcare Provider Details

I. General information

NPI: 1316918741
Provider Name (Legal Business Name): ALBERT JAMES STONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 NE 3RD ST
BEND OR
97701-4333
US

IV. Provider business mailing address

18160 COTTONWOOD RD #499
SUNRIVER OR
97707-9317
US

V. Phone/Fax

Practice location:
  • Phone: 541-388-7799
  • Fax: 541-389-4096
Mailing address:
  • Phone: 541-593-5515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD16137
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: