Healthcare Provider Details

I. General information

NPI: 1851325146
Provider Name (Legal Business Name): ANDREW L STONE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#4 PENDLETON ST
MIDDLEBURG VA
20118
US

IV. Provider business mailing address

5932 LAKE SUNSET LANE
HUME VA
22639
US

V. Phone/Fax

Practice location:
  • Phone: 540-687-3634
  • Fax: 540-687-3378
Mailing address:
  • Phone: 540-687-3634
  • Fax: 540-687-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618000239
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: