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General NPI Number Information
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NPI Number | 1316074776
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Entity Type | Individual
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Provider Name | STEPHEN E SOUTHARD JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1160 HICKORY WAY
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City | ERIE
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State | CO
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Zip | 80516-7994
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Country | US
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Telephone | 617-840-8445
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Fax | 617-789-9549
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Provider Business Mailing Address
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Address Line | 1160 HICKORY WAY
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City | ERIE
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State | CO
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Zip | 80516-7994
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Country | US
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Telephone | 617-840-8445
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Fax | 617-789-9549
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L-228504
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 38056
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 18759
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 59425
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11224295-1205
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License Number State | UT
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C197633
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01094663A
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License Number State | IN
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Taxonomy #8
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 102003
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2024036775
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License Number State | MO
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Taxonomy #10
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2024-02849
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License Number State | NC
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Taxonomy #11
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | V5609
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License Number State | TX
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Taxonomy #12
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 1043889967
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License Number State | NY
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Taxonomy #13
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 1992372403
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License Number State | CT
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Taxonomy #14
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 1992372403
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License Number State | NJ
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Taxonomy #15
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | CDRH.0061297
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License Number State | CO
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