Individual
BLAKE AUSTIN STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD STE 601, CHARLOTTE, NC 28203-5871
(704) 355-7874
(704) 355-5619
Mailing address
338 OLDHAM AVE, LEXINGTON, KY 40502-1720
(859) 640-3310
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2022
Last updated
03/27/2022
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