Individual
ETHAN ARTHUR STONEROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-7999
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08367
NC
363A00000X
Physician Assistant
PA9106601
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006614900
—
FL
Enumeration date
06/27/2012
Last updated
08/30/2022
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