Provider Demographics
NPI:1144762741
Name:STONE, WILLIAM DAVID (LPTA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:STONE
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 HOLCOMB BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3903
Mailing Address - Country:US
Mailing Address - Phone:228-872-6821
Mailing Address - Fax:228-872-6891
Practice Address - Street 1:900 HOLCOMB BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3903
Practice Address - Country:US
Practice Address - Phone:228-872-6821
Practice Address - Fax:228-872-6891
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPTA5405225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
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