Provider Demographics
NPI:1821091844
Name:STONE, MICHELLE HAMES (AUD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:HAMES
Last Name:STONE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 HIGHWAY 54 W STE 203
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4513
Mailing Address - Country:US
Mailing Address - Phone:770-631-1833
Mailing Address - Fax:770-461-9402
Practice Address - Street 1:550 EAGLES LANDING PKWY STE 201
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9082
Practice Address - Country:US
Practice Address - Phone:770-507-0384
Practice Address - Fax:770-507-4629
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD0003986231H00000X
AL760A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51030995Medicare ID - Type Unspecified
ALS19712Medicare UPIN