Healthcare Provider Details

I. General information

NPI: 1962420406
Provider Name (Legal Business Name): DARA J STEPP D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 HARRODSBURG RD STE 125
LEXINGTON KY
40504-3543
US

IV. Provider business mailing address

793 EASTERN BYP SUITE 201
RICHMOND KY
40475-2422
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6371
  • Fax: 859-257-3585
Mailing address:
  • Phone: 859-624-6560
  • Fax: 859-624-6569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number1854
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02970
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: