Individual
STEVEN W ETHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1204 WILLIAMS ST, OAKLAND CITY, IN 47660-1001
(812) 749-6187
(812) 749-4966
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 749-6187
(812) 749-4966
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003011A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000522101
BCBS PIN
IN
05
—
200808030
—
IN
Enumeration date
09/13/2006
Last updated
01/03/2013
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