Provider Demographics
NPI:1508178336
Name:STONE, RICHARD DARREN (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DARREN
Last Name:STONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 MEDICAL CENTER CIR
Mailing Address - Street 2:200
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-1189
Mailing Address - Country:US
Mailing Address - Phone:270-251-4545
Mailing Address - Fax:270-251-4086
Practice Address - Street 1:1029 MEDICAL CENTER CIR
Practice Address - Street 2:200
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-1189
Practice Address - Country:US
Practice Address - Phone:270-251-4545
Practice Address - Fax:270-251-4086
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11015675207Q00000X
KY03609207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine