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General NPI Number Information
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NPI Number | 1407951734
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Entity Type | Individual
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Provider Name | STEVEN W ETHERTON DO
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 1204 WILLIAMS ST
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City | OAKLAND CITY
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State | IN
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Zip | 47660-1001
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Country | US
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Telephone | 812-749-6187
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Fax | 812-749-4966
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Provider Business Mailing Address
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Address Line | PO BOX 1510
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City | EVANSVILLE
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State | IN
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Zip | 47706-1510
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Country | US
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Telephone | 812-749-6187
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Fax | 812-749-4966
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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 | 02003011A
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License Number State | IN
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