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General NPI Number Information
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NPI Number | 1750571006
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Entity Type | Individual
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Provider Name | DOUG STEVENS
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Gender | Male
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 10001 W BELL RD 139
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City | SUN CITY
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State | AZ
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Zip | 85351-1282
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Country | US
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Telephone | 623-815-1636
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Fax | 623-815-6778
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Provider Business Mailing Address
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Address Line | 10001 W BELL RD 139
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City | SUN CITY
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State | AZ
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Zip | 85351-1282
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Country | US
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Telephone | 623-815-1636
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Fax | 623-815-6778
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 768
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License Number State | AZ
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