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NPI Code Detail

MEDICARE: AMY M. STEPHENS, O.D., P.A.

MEDICARE: AMY M. STEPHENS, O.D., P.A.
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
1152W00000XOptometrist001621GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
207566OTHERGASPECTERA
344253OTHERGAAVESIS-GROUP
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891817573
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMY M. STEPHENS, O.D., P.A.
Provider Business Mailing Address
First Line : 1480 TIMBERLANE RD
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32312-1713
Country : US
Telephone Number : 850-894-2332
Fax Number : 850-668-8625
Provider Business Practice Location Address
First Line : 15196 US HIGHWAY 19 S
Second Line :
City : THOMASVILLE
State : GA
Zip : 31757-4820
Country : US
Telephone Number : 229-228-4770
Fax Number : 229-225-9060
Authorized Official
Title or Position : DOCTOR, OWNER
Name : DR. AMY M. STEPHENS
Credential : O.D.
Telephone Number : 229-228-4770
Provider Enumeration Date : 04/04/2007
Last Update Date : 08/12/2008

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