Provider Demographics
NPI:1932117264
Name:STONE, PHILLIP A (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:A
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3455 MAIN ST
Mailing Address - Street 2:STE # 5
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1142
Mailing Address - Country:US
Mailing Address - Phone:413-733-9600
Mailing Address - Fax:413-732-6534
Practice Address - Street 1:3455 MAIN ST
Practice Address - Street 2:STE # 5
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1142
Practice Address - Country:US
Practice Address - Phone:413-733-9600
Practice Address - Fax:413-732-6534
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2010-11-15
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Provider Licenses
StateLicense IDTaxonomies
MA32201208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAC05024Medicare ID - Type Unspecified
MAB95295Medicare UPIN