Individual
DR. KENNETH A STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 UTICA AVE, LUBBOCK, TX 79416-3111
(806) 797-4985
(806) 792-8588
Mailing address
301 UTICA AVE, LUBBOCK, TX 79416-3111
(806) 797-4985
(806) 792-8588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J0871
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104069302
—
TX
Enumeration date
06/10/2005
Last updated
02/10/2022
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