Provider Demographics
NPI:1851597603
Name:STONE VISION CENTER, PA
Entity Type:Organization
Organization Name:STONE VISION CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-825-8900
Mailing Address - Street 1:8465 EDGEMONT RD
Mailing Address - Street 2:
Mailing Address - City:GREERS FERRY
Mailing Address - State:AR
Mailing Address - Zip Code:72067-9751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8465 EDGEMONT RD
Practice Address - Street 2:
Practice Address - City:GREERS FERRY
Practice Address - State:AR
Practice Address - Zip Code:72067-9751
Practice Address - Country:US
Practice Address - Phone:501-825-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2438152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR16751000040OtherQUAL CHOICE
ARU56720Medicare UPIN
AR5T078Medicare ID - Type Unspecified
AR1156990001Medicare NSC