Provider Demographics
NPI:1104562420
Name:STONECIPHER, ERIC DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVID
Last Name:STONECIPHER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32160
Mailing Address - Street 2:DEPT 107
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40232-2160
Mailing Address - Country:US
Mailing Address - Phone:513-699-9090
Mailing Address - Fax:
Practice Address - Street 1:4001 ROSSLYN DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1111
Practice Address - Country:US
Practice Address - Phone:513-699-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.017763207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine