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NPI Code Detail

MEDICARE: DR. KENNETH DAVID STONE MD

MEDICARE: DR. KENNETH DAVID STONE 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
1207Q00000XFamily Medicine Physician37010MO

Other Identifiers

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

General Provider Information

NPI Number : 1578559027
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH DAVID STONE MD
Provider Business Mailing Address
First Line : 121 SMITH AVE
Second Line :
City : SIKESTON
State : MO
Zip : 63801-5239
Country : US
Telephone Number : 573-471-0200
Fax Number : 573-472-3026
Provider Business Practice Location Address
First Line : 121 SMITH AVE
Second Line :
City : SIKESTON
State : MO
Zip : 63801-5239
Country : US
Telephone Number : 573-471-0200
Fax Number : 573-472-3026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 03/21/2017

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Directions to “ DR. KENNETH DAVID STONE MD” Practice Location

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