Healthcare Provider Details

I. General information

NPI: 1306820352
Provider Name (Legal Business Name): PAUL VICTOR STEPHENS MS CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S 3RD ST
GADSDEN AL
35901
US

IV. Provider business mailing address

510 S 3RD ST
GADSDEN AL
35901
US

V. Phone/Fax

Practice location:
  • Phone: 256-543-3221
  • Fax: 256-543-9354
Mailing address:
  • Phone: 256-543-3221
  • Fax: 256-543-9354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number791A
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number791A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: