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General NPI Number Information
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NPI Number | 1245379981
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Entity Type | Individual
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Provider Name | ANDREW STONE O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 2012 CHERRY HILL DR SUITE 201
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City | COLUMBIA
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State | MO
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Zip | 65203-5882
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Country | US
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Telephone | 573-445-7750
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Fax | 573-445-7752
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Provider Business Mailing Address
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Address Line | 2012 CHERRY HILL DR STE 201
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City | COLUMBIA
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State | MO
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Zip | 65203-5882
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Country | US
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Telephone | 573-445-1060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2002022349
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License Number State | MO
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