Organization
E KENT STEVENSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD KENT STEVENSON M.D. (PRESIDENT)
(913) 649-5567
Entity
Organization
Contact information
Practice address
5200 W 94TH TER, SUITE 105, PRAIRIE VILLAGE, KS 66207-2522
(913) 649-5567
(913) 649-7563
Mailing address
5200 W 94TH TER, SUITE 105, PRAIRIE VILLAGE, KS 66207-2522
(913) 649-5567
(913) 649-7563
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0415789
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04563147
BLUE CROSS BLUE SHIELD
KS
Enumeration date
03/16/2010
Last updated
04/22/2010
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