Provider Demographics
NPI:1417992421
Name:STONE, DONALD JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JAMES
Last Name:STONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 46
Mailing Address - Street 2:401 SHICKSHINNY LAKE RD
Mailing Address - City:HUNTINGTON MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:18622
Mailing Address - Country:US
Mailing Address - Phone:570-864-3191
Mailing Address - Fax:570-864-2569
Practice Address - Street 1:401 SHICKSHINNY LAKE RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON MILLS
Practice Address - State:PA
Practice Address - Zip Code:18622
Practice Address - Country:US
Practice Address - Phone:570-864-3191
Practice Address - Fax:570-864-2569
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004366L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00188428OtherHIGHMARK BS
PA13004OtherGEISINGER HEALTH PLAN
50071570OtherKEYSTONE CBC
003002OtherFIRST PRIORITY HEALTH
PA0014475310001Medicaid
00188428OtherHIGHMARK BS
ST188428Medicare PIN
50071570OtherKEYSTONE CBC