Individual
ISHMAEL WORTH STEVENS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 13TH ST, ASHLAND, KY 41101
(606) 329-0204
(606) 324-7770
Mailing address
700 13TH ST, ASHLAND, KY 41101
(606) 329-0204
(606) 324-7770
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35295
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000111530
ANTHEM BC
KY
01
—
1200987
UNITED HEALTH CARE
KY
01
—
336109752062214
BC SUPER BLUE PLUS
KY
05
—
64012503
—
KY
05
—
65917544
—
KY
05
—
6700603-000
—
WV
Enumeration date
10/04/2006
Last updated
07/09/2007
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