Healthcare Provider Details

I. General information

NPI: 1922191881
Provider Name (Legal Business Name): JAMES R STEFURAK PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 UNIVERSITY BLVD NORTH STE 2000, UNIVERSITY COMMONS
MOBILE AL
36688-0001
US

IV. Provider business mailing address

307 UNIVERSITY BLVD NORTH STE 2000, UNIVERSITY COMMONS
MOBILE AL
36688-0001
US

V. Phone/Fax

Practice location:
  • Phone: 251-460-7149
  • Fax: 251-460-7267
Mailing address:
  • Phone: 251-460-7149
  • Fax: 251-460-7267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1356
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: