MEDICARE: DR. BENJAMIN DAVID STONE OD

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	152W00000X	Optometrist	1583	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21-000595	OTHER	MN	MEDICA
2	111184	OTHER	MN	UCARE
3	MN1583	OTHER	MN	EYEMED
4	16255	OTHER	MN	SPECTERA
5	4C992ST	OTHER	MN	BLUE CROSS
6	52902	OTHER	MS	DAVIS VISION
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811185630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN DAVID STONE OD

Provider Business Mailing Address
First Line	:	340 3RD ST
Second Line	:
City	:	INTL FALLS
State	:	MN
Zip	:	56649-2309
Country	:	US
Telephone Number	:	218-283-4788
Fax Number	:

Provider Business Practice Location Address
First Line	:	340 3RD ST
Second Line	:
City	:	INTL FALLS
State	:	MN
Zip	:	56649-2309
Country	:	US
Telephone Number	:	218-283-4788
Fax Number	:

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

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	05/14/2008

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