Organization
DR. T. SHAWN STEPHENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY SHAWN STEPHENS OD (OWNER)
(304) 485-1199
Entity
Organization
Contact information
Practice address
244 GRAND CENTRAL MALL, VIENNA, WV 26101-1105
(304) 485-1199
(304) 428-8102
Mailing address
244 GRAND CENTRAL MALL, VIENNA, WV 26101-1105
(304) 485-1199
(304) 428-8102
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1004-D
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001212
—
WV
Enumeration date
11/14/2007
Last updated
07/02/2015
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