Individual
DR. JEFFREY PATRICK STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 MONTGOMERY ST, CUSTER, SD 57730-1705
(605) 673-9400
Mailing address
11903 EMERALD RD, CUSTER, SD 57730-8172
(313) 580-3861
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17584
SD
390200000X
Student in an Organized Health Care Education/Training Program
TL.0009417
CO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/03/2019
Last updated
07/18/2025
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