Provider Demographics
NPI:1588624449
Name:STONE, PERRY GALE (MD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:GALE
Last Name:STONE
Suffix:
Gender:F
Credentials:MD
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 426
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-0426
Mailing Address - Country:US
Mailing Address - Phone:336-983-2531
Mailing Address - Fax:336-983-2531
Practice Address - Street 1:132 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-9011
Practice Address - Country:US
Practice Address - Phone:336-983-2531
Practice Address - Fax:336-983-2532
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20973208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF18575Medicare UPIN