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NPI Code Detail

MEDICARE: JAMES W. STEVENS

MEDICARE: JAMES W. STEVENS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2730WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22730OTHERWIWI P.T. LICENSE

General Provider Information

NPI Number : 1255527644
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES W. STEVENS
Provider Business Mailing Address
First Line : 11333 W NATIONAL AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-3111
Country : US
Telephone Number : 414-327-2295
Fax Number :
Provider Business Practice Location Address
First Line : 11333 W NATIONAL AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-3111
Country : US
Telephone Number : 414-327-2295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2007
Last Update Date : 09/19/2007

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