Provider Demographics
NPI:1952837676
Name:STONE, STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:STONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 PASS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-3105
Mailing Address - Country:US
Mailing Address - Phone:228-575-8660
Mailing Address - Fax:228-575-8531
Practice Address - Street 1:38 PASS RD
Practice Address - Street 2:SUITE C
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3105
Practice Address - Country:US
Practice Address - Phone:228-575-8660
Practice Address - Fax:228-575-8531
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor