Individual
JOHN A. STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-9639
(601) 703-3273
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA009
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009949515
—
AL
05
—
01787006
—
MS
01
—
P00113835
RAILROAD MEDICARE
—
Enumeration date
11/22/2005
Last updated
03/22/2013
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