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General NPI Number Information
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NPI Number | 1164530382
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Entity Type | Organization
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Legal Business Name | MICHAEL A. STEPHENS MD PA
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1701 PARK AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-4946
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Country | US
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Telephone | 904-510-2382
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Fax | 904-407-7839
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Provider Business Mailing Address
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Address Line | 1701 PARK AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-4946
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Country | US
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Telephone | 904-982-6453
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Fax | 904-407-7839
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MICHAEL ANTHONY STEPHENS
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Credential |
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Telephone | 904-510-2382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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