MEDICARE: DR. JAMES CLAY STEPHENS M.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
1	207R00000X	Internal Medicine Physician	01057778A	IN

General Provider Information

NPI Number	:	1447230875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES CLAY STEPHENS M.D.

Provider Business Mailing Address
First Line	:	200 BRULE ST BLDG IRELAND
Second Line	:
City	:	FORT KNOX
State	:	KY
Zip	:	40121-6100
Country	:	US
Telephone Number	:	502-624-9007
Fax Number	:	502-624-0252

Provider Business Practice Location Address
First Line	:	200 BRULE ST BLDG IRELAND
Second Line	:
City	:	FORT KNOX
State	:	KY
Zip	:	40121-6100
Country	:	US
Telephone Number	:	502-624-3149
Fax Number	:	502-624-0252

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	06/20/2025

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