| Katherine Stone DO PLLC | |
|
1645 S Main St Ste 101 Crossville TN 38555-5998 | |
| (931) 484-7531 | |
| (931) 456-9515 |
| Full Name | Katherine Stone DO PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1645 S Main St Ste 101, Crossville, Tennessee |
| Authorized Official Name and Position | Katherine Marie Stone (OWNER) |
| Authorized Official Contact | 9314847531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine Stone DO PLLC 1645 S Main St Ste 101 Crossville TN 38555-5998 Ph: (931) 484-7531 | Katherine Stone DO PLLC 1645 S Main St Ste 101 Crossville TN 38555-5998 Ph: (931) 484-7531 |
| NPI Number | 1891441655 |
|---|---|
| Provider Enumeration Date | 03/01/2022 |
| Last Update Date | 03/01/2022 |
| Certification Date | 03/01/2022 |
| Medicare PECOS PAC ID | 5294119863 |
|---|---|
| Medicare Enrollment ID | O20220831000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891441655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Katherine M Charnley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811343551 PECOS PAC ID: 8921391814 Enrollment ID: I20190926003533 |
| Provider Name | Kyle Jeffrey Charnley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114740040 PECOS PAC ID: 5890223242 Enrollment ID: I20250113001989 |
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