Healthcare Provider Details

I. General information

NPI: 1164402426
Provider Name (Legal Business Name): STEVEN C DEWBERRY C.R.N.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HOSPITAL RD
STARKVILLE MS
39759-2163
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 662-323-4230
  • Fax: 662-615-2554
Mailing address:
  • Phone: 901-226-4003
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR850858
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: