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General NPI Number Information
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NPI Number | 1740297175
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Entity Type | Individual
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Provider Name | STEPHEN REPLOGLE D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 11871 S FORTUNA RD
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City | YUMA
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State | AZ
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Zip | 85367-7686
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Country | US
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Telephone | 928-342-9020
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Fax | 928-342-2158
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Provider Business Mailing Address
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Address Line | 11871 S FORTUNA RD
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City | YUMA
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State | AZ
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Zip | 85367-7686
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Country | US
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Telephone | 928-342-9020
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Fax | 928-342-2158
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2757
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License Number State | AZ
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