Provider Demographics
NPI:1831815497
Name:STONE, ADAM LANE
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:LANE
Last Name:STONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BLOOMSBURY CT
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1136
Mailing Address - Country:US
Mailing Address - Phone:601-818-9182
Mailing Address - Fax:
Practice Address - Street 1:7 BLOOMSBURY CT
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1136
Practice Address - Country:US
Practice Address - Phone:601-818-9182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program