Provider Demographics
NPI:1649386764
Name:STONE, RODNEY EDMUND (MD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:EDMUND
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WYOMING STREET
Mailing Address - Street 2:STE 4
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2742
Mailing Address - Country:US
Mailing Address - Phone:937-223-0294
Mailing Address - Fax:937-223-7334
Practice Address - Street 1:160 WYOMING STREET
Practice Address - Street 2:STE 4
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2742
Practice Address - Country:US
Practice Address - Phone:937-223-0294
Practice Address - Fax:937-223-7334
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053035S207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0647849Medicaid
A16412Medicare UPIN
OH0647849Medicaid