Healthcare Provider Details

I. General information

NPI: 1780865774
Provider Name (Legal Business Name): THOMAS N STEPHENSON, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2007
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 FINLEY GOLF COURSE RD SUITE 202
CHAPEL HILL NC
27517-4400
US

IV. Provider business mailing address

194 FINLEY GOLF COURSE RD SUITE 202
CHAPEL HILL NC
27517-4400
US

V. Phone/Fax

Practice location:
  • Phone: 919-929-1101
  • Fax: 919-929-1148
Mailing address:
  • Phone: 919-929-1101
  • Fax: 919-929-1148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number19829
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number19829
License Number StateNC

VIII. Authorized Official

Name: DR. THOMAS NOEL STEPHENSON
Title or Position: PRESIDENT
Credential: M,D.
Phone: 919-929-1101