Healthcare Provider Details

I. General information

NPI: 1497495501
Provider Name (Legal Business Name): DORIAN JAMAR STEVENS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S DOBSON RD
MESA AZ
85202-4707
US

IV. Provider business mailing address

3425 E MOCKINGBIRD DR
GILBERT AZ
85234-2224
US

V. Phone/Fax

Practice location:
  • Phone: 480-412-3000
  • Fax:
Mailing address:
  • Phone: 412-266-0339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number012218
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: