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NPI Code Detail

MEDICARE: TODD RUSSELL STEPHENS D.O.

MEDICARE:   TODD RUSSELL STEPHENS  D.O.
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
12085R0202XDiagnostic Radiology Physician3492IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00013853OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
434129OTHERBCBS OF IOWA
534130OTHERBCBS OF IOWA

General Provider Information

NPI Number : 1598725707
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD RUSSELL STEPHENS D.O.
Provider Business Mailing Address
First Line : 4200 UNIVERSITY AVE
Second Line : SUITE 104
City : WEST DES MOINES
State : IA
Zip : 50266-5945
Country : US
Telephone Number : 515-226-7426
Fax Number :
Provider Business Practice Location Address
First Line : 2720 STONE PARK BLVD
Second Line :
City : SIOUX CITY
State : IA
Zip : 51104-3734
Country : US
Telephone Number : 712-279-3285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 09/17/2013

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Directions to “ TODD RUSSELL STEPHENS D.O.” Practice Location

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