Provider Demographics
NPI:1316918741
Name:STONE, ALBERT JAMES (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:JAMES
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:18160 COTTONWOOD RD
Mailing Address - Street 2:#499
Mailing Address - City:SUNRIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97707-9317
Mailing Address - Country:US
Mailing Address - Phone:541-593-5515
Mailing Address - Fax:
Practice Address - Street 1:1302 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4333
Practice Address - Country:US
Practice Address - Phone:541-388-7799
Practice Address - Fax:541-389-4096
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD16137207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR061700Medicaid
ORMD16137OtherMEDICAL LICENSE
ORBS2237255OtherDEA
ORMD16137OtherMEDICAL LICENSE
A50183Medicare UPIN