MEDICARE: JULIA C 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
1	207W00000X	Ophthalmology Physician	28392	KY
2	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	28392	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881793834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA C STEVENS

Provider Business Mailing Address
First Line	:	110 CONN TER STE 550
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40508-3206
Country	:	US
Telephone Number	:	859-323-5867
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 CONN TER STE 550
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40508-3206
Country	:	US
Telephone Number	:	859-323-5867
Fax Number	:

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	03/17/2018

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