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General NPI Number Information
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NPI Number | 1184610800
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Entity Type | Individual
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Provider Name | TERRY KULIA STEVENSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 2503 S AVENUE A STE 2
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City | YUMA
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State | AZ
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Zip | 85364-7174
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Country | US
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Telephone | 928-783-0092
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 669
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City | YUMA
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State | AZ
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Zip | 85366-2329
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Country | US
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Telephone | 928-345-2150
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Fax | 928-345-2151
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7725
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 7725
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 58583
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 58583
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License Number State | AZ
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