Doctor Name: | DR. TODD STEPHENSON |
NPI Number: | 1992820013 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DMD |
License Number: | 5460 |
Business Practice Address: | 405 North Main Street Burkesville, KY - 42717 |
Business Phone Number: | 2708643465 |
Business Fax Number: | 2708643496 |
Mailing Address: | Po Box 376, BURKESVILLE |
State: | KY |
Postal Code: | 427170376 |
Phone Number: | 2708643465 |
Fax Number: | 2708643496 |
NPI Enumeration Date: | 03/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5460 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |