Provider Demographics
NPI:1588648729
Name:STONE, DONALD L (DPM)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:L
Last Name:STONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 W MARKET ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3608
Mailing Address - Country:US
Mailing Address - Phone:330-867-3376
Mailing Address - Fax:330-867-3377
Practice Address - Street 1:3090 W MARKET ST
Practice Address - Street 2:SUITE 112
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3608
Practice Address - Country:US
Practice Address - Phone:330-867-3376
Practice Address - Fax:330-867-3377
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003271S213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2436554Medicaid
OH5526360001Medicare NSC
OH9912431Medicare PIN
OH2436554Medicaid
OHP00069411Medicare PIN