MEDICARE: DR. DALLAS SHONE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	MD25581	TN
2	207RG0100X	Gastroenterology Physician	0101051162	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043213101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALLAS SHONE MD

Provider Business Mailing Address
First Line	:	PO BOX 9
Second Line	:
City	:	KINGSPORT
State	:	TN
Zip	:	37662-0009
Country	:	US
Telephone Number	:	423-857-2066
Fax Number	:	423-857-2070

Provider Business Practice Location Address
First Line	:	105 W STONE DR
Second Line	:	STE 4C
City	:	KINGSPORT
State	:	TN
Zip	:	37660-3256
Country	:	US
Telephone Number	:	423-578-1595
Fax Number	:	423-392-6624

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/07/2014

Similar Medicare Providers

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Practice Location Address:

105 W STONE DR , STE 4D
KINGSPORT, TN
37660-3256

Practice Phone: 423-392-6299
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1255334298 — DR. JEFFREY HUNT MD
Practice Location Address:

105 W STONE DR , STE 4D
KINGSPORT, TN
37660-3256

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1043213994 — DR. EDWARD MONTY STIRMAN M.D.
Practice Location Address:

105 W STONE DR , STE 3A
KINGSPORT, TN
37660-3256

Practice Phone: 423-323-6200
Practice Fax: 423-323-6593

1538162490 — EMILY HUBBS M.D.
Practice Location Address:

105 W STONE DR , STE 3A
KINGSPORT, TN
37660-3256

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1073516886 — DR. SCOTT FOWLER M.D.
Practice Location Address:

105 W STONE DR , STE 2B
KINGSPORT, TN
37660-3256

Practice Phone: 423-247-7500
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1386647006 — DR. ALICIA WRIGHT MD
Practice Location Address:

105 W STONE DR , STE 2A
KINGSPORT, TN
37660-3256

Practice Phone: 423-224-3375
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Directions to “ DR. DALLAS SHONE MD” Practice Location

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