# STEPHENS CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942408216
- **Authorized official:** DR. RUSSELL L STEPHENS M.D. (OWNER)
- **Authorized official phone:** (706) 863-7021

## Contact information

- **Practice address:** 1109 MEDICAL CENTER DR, SUITE 8A, AUGUSTA, GA 30909-6633
- **Practice address phone:** (706) 863-7021
- **Practice address fax:** (706) 651-6322
- **Mailing address:** 1109 MEDICAL CENTER DR, SUITE 8A, AUGUSTA, GA 30909-6633
- **Mailing address phone:** (706) 863-7021
- **Mailing address fax:** (706) 651-6322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 040246 | GA | Yes |

## Other

- **Enumeration date:** 07/06/2007
- **Last updated:** 01/22/2013