Provider Demographics
NPI:1770151763
Name:STONE, JESSICA LAUREN (OD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LAUREN
Last Name:STONE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:LAUREN
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5550 WARES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2113
Mailing Address - Country:US
Mailing Address - Phone:334-271-3937
Mailing Address - Fax:334-657-4234
Practice Address - Street 1:5550 WARES FERRY RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2113
Practice Address - Country:US
Practice Address - Phone:334-271-3937
Practice Address - Fax:334-279-7434
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-E84152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist