Provider Demographics
NPI:1083648935
Name:VAN STONE, JOHN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:VAN STONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3300 LEMONE INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8246
Mailing Address - Country:US
Mailing Address - Phone:573-443-1531
Mailing Address - Fax:573-449-3458
Practice Address - Street 1:3300 LEMONE INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8246
Practice Address - Country:US
Practice Address - Phone:573-443-1531
Practice Address - Fax:573-449-3458
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR5733207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA11198Medicare UPIN