Basic Information
| Provider Information | |||||||||
| NPI: | 1508178336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STONE | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | DARREN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1029 MEDICAL CENTER CIR | ||||||||
| Address2: | 200 | ||||||||
| City: | MAYFIELD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420661189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2702514545 | ||||||||
| FaxNumber: | 2702514086 | ||||||||
| Practice Location | |||||||||
| Address1: | 1029 MEDICAL CENTER CIR | ||||||||
| Address2: | 200 | ||||||||
| City: | MAYFIELD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420661189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2702514545 | ||||||||
| FaxNumber: | 2702514086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2010 | ||||||||
| LastUpdateDate: | 07/16/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 11015675 | IN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 03609 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.