Provider Demographics
NPI:1750348330
Name:STONE, GREGORY A (DO)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:A
Last Name:STONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3336 S 4155 W, SUITE 204
Mailing Address - Street 2:WESTERN HILLS MEDICAL CLINIC
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120
Mailing Address - Country:US
Mailing Address - Phone:801-912-9700
Mailing Address - Fax:801-912-9710
Practice Address - Street 1:3336 S 4155 W, SUITE 204
Practice Address - Street 2:WESTERN HILLS MEDICAL CLINIC
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120
Practice Address - Country:US
Practice Address - Phone:801-912-9700
Practice Address - Fax:801-912-9710
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT180477-1204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F63196Medicare UPIN
UTU000085860-EFF3/3/14Medicare PIN
UT005749011Medicare PIN