MEDICARE: JEFFREY A STEPHENSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	10665	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M000009936	OTHER		PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053312900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY A STEPHENSON MD

Provider Business Mailing Address
First Line	:	PO BOX 31001
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91110-4114
Country	:	US
Telephone Number	:	406-327-1919
Fax Number	:	406-329-2937

Provider Business Practice Location Address
First Line	:	500 W BROADWAY ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-4008
Country	:	US
Telephone Number	:	406-329-5655
Fax Number	:	406-329-5675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	03/05/2026

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