MEDICARE: STONE FAMILY PRACTICE PLLC

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	363LF0000X	Family Nurse Practitioner
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1609217868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONE FAMILY PRACTICE PLLC

Provider Business Mailing Address
First Line	:	1019 PADUCAH RD STE B
Second Line	:
City	:	MAYFIELD
State	:	KY
Zip	:	42066-3616
Country	:	US
Telephone Number	:	270-970-0924
Fax Number	:	866-985-7514

Provider Business Practice Location Address
First Line	:	1019 PADUCAH RD STE B
Second Line	:
City	:	MAYFIELD
State	:	KY
Zip	:	42066-3616
Country	:	US
Telephone Number	:	270-970-0924
Fax Number	:	866-985-7514

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. RICHARD DARREN STONE
Credential	:	DO
Telephone Number	:	270-804-7408

Provider Enumeration Date	:	07/16/2013
Last Update Date	:	04/23/2024

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