Provider Demographics
NPI:1114910767
Name:STONE, TODD I (PA-C)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:I
Last Name:STONE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 COOLRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2767
Mailing Address - Country:US
Mailing Address - Phone:828-694-3939
Mailing Address - Fax:828-692-0533
Practice Address - Street 1:165 COOLRIDGE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2767
Practice Address - Country:US
Practice Address - Phone:828-694-3939
Practice Address - Fax:828-692-0533
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76999363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2746425EMedicare ID - Type Unspecified
S61125Medicare UPIN