Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 24639 | TN |
Y | 207W00000X | Ophthalmologist | MD24639 | TN |
NPI | 1033115373 |
---|---|
Provider Name | Dr. John L Stone |
First Address | Chattanooga, TN 37421-3042 |
Second Address | Chattanooga, TN 37421-3042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 11/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00557917B | (05) | GA |
009930215 | (05) | AL |
3076112 | (05) | TN |
3076114 | (05) | TN |
4269969 | BCBS TN (01) | TN |
4273383 | BCBS TN (01) | TN |
D42255 | (02) | TN |
P00880861 | RAILROAD MEDICARE (01) | TN |