Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD471274 | PA |
NPI | 1154700730 |
---|---|
Provider Name | Dr. Jordan Emerson Stone |
First Address | Philadelphia, PA 19107-6130 |
Second Address | Philadelphia, PA 19107-6130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2015 |
Last Update Date | 26/08/2020 |