Provider Demographics
NPI:1417078197
Name:STONE, BARTLETT A (ANESTHESIOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:BARTLETT
Middle Name:A
Last Name:STONE
Suffix:
Gender:M
Credentials:ANESTHESIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-0515
Mailing Address - Country:US
Mailing Address - Phone:304-736-6126
Mailing Address - Fax:304-736-1531
Practice Address - Street 1:2900 1ST AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1241
Practice Address - Country:US
Practice Address - Phone:304-736-6126
Practice Address - Fax:304-736-1531
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16557174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001721137OtherWV BLUE CROSS
WV0059738000Medicaid
WV550696369-00OtherWV WORKERS COMP
WV0705041Medicare PIN
WVE01374Medicare UPIN
WV0059738000Medicaid