Doctor Name: | BENJAMIN DAVID STEPHENSON |
NPI Number: | 1679771414 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 0433764 |
Business Practice Address: | 1719 Highway 183 Phillipsburg, KS - 676612549 |
Business Phone Number: | 7855435211 |
Business Fax Number: | 7855435274 |
Mailing Address: | 1719 Highway 183, Po Box 547 PHILLIPSBURG |
State: | KS |
Postal Code: | 676612549 |
Phone Number: | 7855435211 |
Fax Number: | 7855435274 |
NPI Enumeration Date: | 07/03/2007 |
NPI Last Update Date: | 02/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0433764 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |