Stone Surgery Clinic

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3024682 Issued in FL

Legal business name

STONE SURGERY CLINIC

Doing business as

Fawaz Medical & Surgical Clinic

Practice address

4417 US Hwy 331 S
Defuniak Springs, FL 32435-6703

Phone

(850) 951-4638

Fax

(850) 951-4554

NPI assigned

Jun 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donna Ward

Title

Office Manager

Phone

(850) 951-4638

Specialties & licenses 1

Addresses

Other names 1

• Fawaz Medical & Surgical Clinic Doing business as

Tax ID family

Fawaz Medical Surgical Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Fawaz Medical & Surgical Clinic

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Defuniak SPGS, FL
  • NPI 1447477484
  NPD tax ID
• Stone Surgery Clinic

  • Surgery Physician
  • Defuniak Springs, FL
  • NPI 1982728929
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073718664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 US HWY 331 S",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324356703",
            "telephone_number": "850-951-4638",
            "fax_number": "850-951-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 US HWY 331 S",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324356703",
            "telephone_number": "850-951-4638",
            "fax_number": "850-951-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE SURGERY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-951-4638"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "3024682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fawaz Medical & Surgical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katie Gilbert Spear, OD
• Heleena Stamaris, RBT
• Makayla Stephens, RBT
• Stephanie Holland Stephens, RPH
• Charles Gordon Stevenson III, OD
• Stone Surgery Clinic
• Sabrina Marie Stout
• Dylan Stovall, LCSW
• Tiana Street, RBT
• Pamela Kay Stuckey

• Nurse Practitioner in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.