Healthcare Provider Details

I. General information

NPI: 1417992421
Provider Name (Legal Business Name): DONALD JAMES STONE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 09/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 SHICKSHINNY LAKE RD
HUNTINGTON MILLS PA
18622
US

IV. Provider business mailing address

PO BOX 46 401 SHICKSHINNY LAKE RD
HUNTINGTON MILLS PA
18622
US

V. Phone/Fax

Practice location:
  • Phone: 570-864-3191
  • Fax: 570-864-2569
Mailing address:
  • Phone: 570-864-3191
  • Fax: 570-864-2569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS004366L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: