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NPI 1467447565

NPI 1467447565 : JAMES H. STEVENS JR. MD : FT WALTON BEACH, FL

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General NPI Number Information
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    NPI Number           |    1467447565
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES H. STEVENS JR. MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/14/2005
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    Last Update Date     |    05/06/2016
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Provider Practice Location Address
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    Address Line         |    1026 MAR WALT DR 
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    City                 |    FT WALTON BEACH
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    State                |    FL
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    Zip                  |    32547-6645
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    Country              |    US
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    Telephone            |    850-863-5294
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    Fax                  |    850-864-1648
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Provider Business Mailing Address
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    Address Line         |    2234 COLONIAL BLVD 
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    City                 |    FORT MYERS
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    State                |    FL
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    Zip                  |    33907-1412
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    Country              |    US
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    Telephone            |    239-931-7342
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    Fax                  |    239-931-7385
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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        |    2085R0001X
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    Taxonomy Name        |    Radiation Oncology Physician
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    License Number       |    ME0068163
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    License Number State |    FL
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