Healthcare Provider Details
I. General information
NPI: 1053307298
Provider Name (Legal Business Name): STEPHEN PATRICK ANTHONY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/22/2005
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
309 E FARWELL RD SUITE 100
SPOKANE WA
99218-8202
US
IV. Provider business mailing address
PO BOX 911230
DALLAS TX
75391-1230
US
V. Phone/Fax
- Phone: 509-464-2873
- Fax: 509-466-0914
- Phone: 972-997-8000
- Fax: 972-234-2987
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | OP00001601 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 4488 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: