Basic Information
Provider Information
NPI: 1558724237
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STONER
FirstName: PATRICK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1901 SE 18TH AVE STE 400
Address2:  
City: OCALA
State: FL
PostalCode: 344718213
CountryCode: US
TelephoneNumber: 3527322440
FaxNumber: 3527322440
Practice Location
Address1: 1901 SE 18TH AVE STE 400
Address2:  
City: OCALA
State: FL
PostalCode: 344718213
CountryCode: US
TelephoneNumber: 3527328905
FaxNumber: 3527322440
Other Information
ProviderEnumerationDate: 03/31/2016
LastUpdateDate: 07/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RG0100XOS18934FLY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


Home