Healthcare Provider Details

I. General information

NPI: 1962471490
Provider Name (Legal Business Name): RONALD LEE STEPHENS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 ARKANSAS ST SUITE 105
LAWRENCE KS
66044-1335
US

IV. Provider business mailing address

330 ARKANSAS ST SUITE 105
LAWRENCE KS
66044-1335
US

V. Phone/Fax

Practice location:
  • Phone: 785-840-2800
  • Fax: 785-840-2813
Mailing address:
  • Phone: 785-840-2800
  • Fax: 785-840-2813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number04-13575
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: