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NPI Code Detail

MEDICARE: KAREN SUZANNE STEPHENS O.D.

MEDICARE: KAREN SUZANNE STEPHENS O.D.
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
1152W00000XOptometrist1425-3KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125423031OTHERKSBLUE CROSS BLUE SHIELD OF KANSAS CITY

General Provider Information

NPI Number : 1326035098
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN SUZANNE STEPHENS O.D.
Provider Business Mailing Address
First Line : 9501 STATE AVE
Second Line : SUITE 2
City : KANSAS CITY
State : KS
Zip : 66111-1872
Country : US
Telephone Number : 913-299-7200
Fax Number : 913-334-4451
Provider Business Practice Location Address
First Line : 9501 STATE AVE
Second Line : SUITE 2
City : KANSAS CITY
State : KS
Zip : 66111-1872
Country : US
Telephone Number : 913-299-7200
Fax Number : 913-334-4451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2005
Last Update Date : 10/23/2009

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