Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 49215 | CO |
N | 2084N0400X | Neurologist | 5101017299 | MI |
NPI | 1023322039 |
---|---|
Provider Name | William Tyler Stone |
First Address | Colorado Springs, CO 80917-3357 |
Second Address | Colorado Springs, CO 80907-7532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2010 |
Last Update Date | 14/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
72728850 | (05) | CO |