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General NPI Number Information
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NPI Number | 1669396263
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Entity Type | Organization
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Legal Business Name | JACKIESTONELLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 2120 E FIRE TOWER RD STE 107-1070
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City | GREENVILLE
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State | NC
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Zip | 27858-9284
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Country | US
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Telephone | 256-280-7922
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Fax |
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Provider Business Mailing Address
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Address Line | 3904 CANTATA DR
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City | GREENVILLE
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State | NC
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Zip | 27858-5328
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Country | US
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Telephone | 256-280-7922
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACQUELYN AMBER STONE
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Credential | MD
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Telephone | 256-280-7922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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