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NPI 1619074622

NPI 1619074622 : DONALD JOE STEPHENSON P.A. : ABILENE, TX

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General NPI Number Information
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    NPI Number           |    1619074622
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    Entity Type          |    Individual 
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    Provider Name        |    DONALD JOE STEPHENSON P.A.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/20/2006
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    Last Update Date     |    03/27/2009
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Provider Practice Location Address
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    Address Line         |    1701 PINE ST 
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    City                 |    ABILENE
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    State                |    TX
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    Zip                  |    79601-3043
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    Country              |    US
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    Telephone            |    325-677-6219
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    Fax                  |    325-677-0129
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Provider Business Mailing Address
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    Address Line         |    1701 PINE ST 
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    City                 |    ABILENE
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    State                |    TX
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    Zip                  |    79601-3043
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    Country              |    US
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    Telephone            |    325-677-6219
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    Fax                  |    325-677-0129
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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        |    363AS0400X
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    Taxonomy Name        |    Surgical Physician Assistant
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    License Number       |    PA03027
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    License Number State |    TX
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