Individual
DR. JOHNNY JOE STEPHENS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1623 MADISON AVE, TIFTON, GA 31794-3757
(229) 353-7720
Mailing address
907 18TH ST E, SUITE 150, TIFTON, GA 31794-3643
(229) 353-7720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
.MD.025534
LA
207R00000X
Internal Medicine Physician
025534
LA
207RH0003X
Hematology & Oncology Physician
Primary
56927
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1576697
—
LA
Enumeration date
10/06/2005
Last updated
12/01/2020
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