Provider Demographics
NPI:1316938335
Name:STONE, BOBBY DEAN JR (RPH, CDM)
Entity type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:DEAN
Last Name:STONE
Suffix:JR
Gender:M
Credentials:RPH, CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S LEROY ST
Mailing Address - Street 2:
Mailing Address - City:METTER
Mailing Address - State:GA
Mailing Address - Zip Code:30439-4631
Mailing Address - Country:US
Mailing Address - Phone:912-685-2803
Mailing Address - Fax:912-685-3777
Practice Address - Street 1:150 S LEROY ST
Practice Address - Street 2:
Practice Address - City:METTER
Practice Address - State:GA
Practice Address - Zip Code:30439-4631
Practice Address - Country:US
Practice Address - Phone:912-685-2803
Practice Address - Fax:912-685-3777
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist