| Organization Name: | STEVENSON MEDICAL CENTER, P.C. |
| NPI Number: | 1033202320 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALAN J WAYNE (CEO) |
| Mailing Address: | 196 County Road 85 Stevenson |
| State: | AL US |
| Postal Code: | 357725522 |
| Phone Number: | 2564372272 |
| Fax Number: | 2564372273 |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 09/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 013785 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |