Individual
CARL WAYNE STEVENS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
203 S 12TH AVE, LAUREL, MS 39440-4324
(601) 649-9706
(601) 649-9708
Mailing address
203 S 12TH AVE, LAUREL, MS 39440-4324
(601) 649-9706
(601) 649-9708
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
15762
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119265
—
MS
Enumeration date
09/20/2006
Last updated
05/18/2011
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