Healthcare Provider Details

I. General information

NPI: 1760002141
Provider Name (Legal Business Name): ABIGAIL ESTHER STEPHENS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2020
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 PIONEER PKWY W
SPRINGFIELD OR
97477-4506
US

IV. Provider business mailing address

214 PIONEER PKWY W
SPRINGFIELD OR
97477-4506
US

V. Phone/Fax

Practice location:
  • Phone: 541-525-9152
  • Fax: 541-452-6573
Mailing address:
  • Phone: 541-525-9152
  • Fax: 541-452-6573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD220493
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: