Organization
STEVENS EYECARE ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANIEL STEVENS O.D. (OPTOMETRIST/OWNER)
(304) 727-5237
Entity
Organization
Contact information
Practice address
205 4TH AVE, SAINT ALBANS, WV 25177-2821
(304) 727-5237
(304) 727-4051
Mailing address
205 4TH AVE, SAINT ALBANS, WV 25177-2821
(304) 727-5237
(304) 727-4051
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WV-1080-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063724003
INDIVIDUAL NPI
—
01
—
WV0297A
MEDICARE PTAN
WV
Enumeration date
07/10/2015
Last updated
07/10/2015
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