Provider Demographics
NPI:1760454789
Name:STONE, P. MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:P.
Middle Name:MICHAEL
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 1:595 N MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1821
Mailing Address - Country:US
Mailing Address - Phone:541-488-1116
Mailing Address - Fax:
Practice Address - Street 1:595 N MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1821
Practice Address - Country:US
Practice Address - Phone:541-488-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD22527207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR131043Medicare PIN
ORE82966Medicare UPIN