Individual
JACK EDWARD STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403
(801) 387-3709
(801) 387-3725
Mailing address
6140 SHARON CIR, OGDEN, UT 84403-5008
(435) 901-2735
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10476493-1205
UT
207R00000X
Internal Medicine Physician
10476493-8905
UT
207R00000X
Internal Medicine Physician
R74955
AZ
Other
Enumeration date
05/12/2015
Last updated
06/21/2018
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