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NPI Code Detail

MEDICARE: DR. NATHAN RHODES STEVENS D.O.

MEDICARE:  DR. NATHAN RHODES STEVENS  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
1207W00000XOphthalmology Physician12275MT
2207W00000XOphthalmology Physician0057503CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00880687OTHERMTRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112275OTHERMTSTATE LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801873401
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN RHODES STEVENS D.O.
Provider Business Mailing Address
First Line : 3155 N UNION BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-8703
Country : US
Telephone Number : 719-630-3937
Fax Number : 719-635-3578
Provider Business Practice Location Address
First Line : 3155 N UNION BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-8703
Country : US
Telephone Number : 719-630-3937
Fax Number : 719-635-3578
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 08/07/2024

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Directions to “ DR. NATHAN RHODES STEVENS D.O.” Practice Location

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