Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | E3987 | AR |
NPI | 1144269317 |
---|---|
Provider Name | David M Stone |
First Address | Van Buren, AR 72956-5321 |
Second Address | Chippewa Falls, WI 54729-5407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 04/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D32893 | (02) |