Provider Demographics
NPI:1174622963
Name:STONE, RAYMOND FRANK JR (PAC)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:FRANK
Last Name:STONE
Suffix:JR
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:NC
Mailing Address - Zip Code:28635-0082
Mailing Address - Country:US
Mailing Address - Phone:336-696-2711
Mailing Address - Fax:336-696-2829
Practice Address - Street 1:5229 ROCK CREEK RD
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:NC
Practice Address - Zip Code:28635-0082
Practice Address - Country:US
Practice Address - Phone:336-696-2711
Practice Address - Fax:336-696-2829
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100339207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2804293Medicare ID - Type UnspecifiedGROUP
2759230Medicare ID - Type UnspecifiedINDIVIDUAL
P98501Medicare UPIN