Provider Demographics
NPI:1336261767
Name:STONE, LINDA ANN (DOM)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANN
Last Name:STONE
Suffix:
Gender:F
Credentials:DOM
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Mailing Address - Street 1:522 W MERMOD ST
Mailing Address - Street 2:SUITE 760
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-4907
Mailing Address - Country:US
Mailing Address - Phone:505-302-1707
Mailing Address - Fax:505-887-6824
Practice Address - Street 1:411 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-6352
Practice Address - Country:US
Practice Address - Phone:505-887-6824
Practice Address - Fax:505-887-6824
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMD.O.M 225 RX2171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist