Healthcare Provider Details

I. General information

NPI: 1881771996
Provider Name (Legal Business Name): STEVEN PHILIP MAGARY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL VILLAGE DR SUITE 268
EDGEWOOD KY
41017-5401
US

IV. Provider business mailing address

40 N GRAND AVE SUITE 101
FORT THOMAS KY
41075-4107
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-1100
  • Fax: 859-344-4443
Mailing address:
  • Phone: 859-781-4900
  • Fax: 859-572-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number35638
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number35638
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number35638
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35638
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: