Individual
PAUL KENNETH STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
801 POLE LINE RD W, MAGIC VALLEY WOMEN'S HEALTH CLINIC, TWIN FALLS, ID 83301-5810
(208) 814-8500
(208) 814-8960
Mailing address
801 POLE LINE RD W, MAGIC VALLEY WOMEN'S HEALTH CLINIC, TWIN FALLS, ID 83301-5810
(208) 814-8500
(208) 814-8960
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
O-0944
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376809202
NPI
ID
Enumeration date
04/04/2012
Last updated
06/17/2016
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