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General NPI Number Information
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NPI Number | 1043537723
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Entity Type | Organization
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Legal Business Name | CHARLES STEPHENS, M.D.
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Dates
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Enumeration Date | 04/21/2010
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 3106 HUDNALL LN
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City | EDGEWOOD
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State | KY
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Zip | 41017-2321
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Country | US
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Telephone | 859-341-7611
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Fax |
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Provider Business Mailing Address
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Address Line | 3106 HUDNALL LN
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City | EDGEWOOD
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State | KY
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Zip | 41017-2321
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Country | US
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Telephone | 859-341-7611
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CHARLES OLIVER STEPHENS
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Credential | M.D.
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Telephone | 859-341-7611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 13750
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License Number State | KY
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