Individual
STEPHEN G VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1425 S US 301, SUMTERVILLE, FL 33585-5141
(352) 793-5900
(352) 793-6269
Mailing address
1425 S US 301, SUMTERVILLE, FL 33585-5141
(352) 793-5900
(352) 793-6269
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS12788
FL
208D00000X
General Practice Physician
Primary
OS12788
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014061400
—
FL
05
—
795005500
—
MD
Enumeration date
01/11/2006
Last updated
03/15/2016
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