Provider Demographics
NPI:1033115373
Name:STONE, JOHN L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7300 JARNIGAN RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3042
Mailing Address - Country:US
Mailing Address - Phone:423-664-3366
Mailing Address - Fax:423-531-2925
Practice Address - Street 1:7300 JARNIGAN RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3042
Practice Address - Country:US
Practice Address - Phone:423-664-3366
Practice Address - Fax:423-531-2925
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24639207W00000X
TNMD24639207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4269969OtherBCBS TN
TN3076114Medicaid
TN4273383OtherBCBS TN
TN3076112Medicaid
GA00557917BMedicaid
AL009930215Medicaid
TNP00880861OtherRAILROAD MEDICARE
GA00557917BMedicaid
TN$$$$$$$$$OtherRAILROAD MEDICARE
TNP00880861OtherRAILROAD MEDICARE
AL009930215Medicaid