Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 535 | MS |
N | 152WP0200X | Pediatric Optomitrist | 535 | MS |
N | 152WS0006X | Sports Vision | 535 | MS |
N | 152WX0102X | Occupational Vision | 535 | MS |
N | 156FC0800X | Contact Lens | 535 | MS |
N | 156FC0801X | Contact Lens Fitter | 535 | MS |
N | 156FX1100X | Ophthalmic | 535 | MS |
NPI | 1992817597 |
---|---|
Provider Name | Dr. Glen H Stone |
First Address | Batesville, MS 38606-2311 |
Second Address | Batesville, MS 38606-2311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 18/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00087100 | (05) | MS |
T21159 | (02) | MS |