Individual
RUSSELL BRYANT STONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2402 MONTGOMERY DR, WILSON, NC 27393-4421
(252) 243-2020
(252) 291-2020
Mailing address
2402 MONTGOMERY DR, WILSON, NC 27393-4421
(252) 243-2020
(252) 291-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1879
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0312480001
PALMETTO GBA
—
01
—
093KW
BCBS
NC
01
—
1568414464
NPI
NC
01
—
2200355
UHC
NC
05
—
89093KU
—
NC
01
—
B9760
MEDCOST
—
01
—
P00249058
RAILROAD MEDICARE
—
Enumeration date
05/17/2006
Last updated
10/12/2012
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