Provider Demographics
NPI:1912967043
Name:STONE, KENNETH ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ALLEN
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KEN
Other - Middle Name:A
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:19845 HAMAL DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9717
Mailing Address - Country:US
Mailing Address - Phone:719-481-9258
Mailing Address - Fax:
Practice Address - Street 1:7500 COCHRANE
Practice Address - Street 2:EVANS ARMY COMMUNITY HOSPITAL BLDG2059 MAGRATH AND YANO
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-526-2939
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25002207Q00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine