Provider Demographics
NPI:1114947488
Name:STONE, MICHELLE A (DO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:STONE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 RUNNING HORSE RD
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7707
Mailing Address - Country:US
Mailing Address - Phone:816-858-7050
Mailing Address - Fax:816-858-7055
Practice Address - Street 1:2703 RUNNING HORSE RD
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-7707
Practice Address - Country:US
Practice Address - Phone:816-858-7050
Practice Address - Fax:816-858-7055
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS531276207Q00000X
MO2012010199207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS104610OtherBC/BS KS AT BRMC
KS104954OtherBC/BS KS AT MVC
MO1114947488Medicaid
KS927709OtherFIRST GUARD
MOP01086090OtherRR MEDICARE
KS200335750AMedicaid
KS200335750AMedicaid
KS104954OtherBC/BS KS AT MVC
MOP01086090OtherRR MEDICARE
MO1114947488Medicaid