Healthcare Provider Details

I. General information

NPI: 1902501018
Provider Name (Legal Business Name): DALLIN STEVENS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S 20TH AVE
SAFFORD AZ
85546-4011
US

IV. Provider business mailing address

3545 W 8TH ST
THATCHER AZ
85552-5449
US

V. Phone/Fax

Practice location:
  • Phone: 928-348-4000
  • Fax:
Mailing address:
  • Phone: 928-651-3747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number73752
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: