Individual
JEFFREY STUART STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9880 ANGIES WAY, 250, LOUISVILLE, KY 40241-2851
(502) 394-6341
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
45055
KY
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
45055
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201221810
—
IN
01
—
50039136
PASSPORT HEALTH- NMA OBC
KY
01
—
6222460
CIGNA- NORTON MEDICAL ASSOCIATES
KY
05
—
7100203090
—
KY
01
—
767416
ANTHEM- NORTON MEDICAL ASSOCIATES
KY
01
—
K043290
MEDICARE- NMA OBC
KY
Enumeration date
04/23/2008
Last updated
10/27/2020
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