Individual
TIMOTHY ROGER STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1075 S HWY 89, MT PLEASANT, UT 84647
(435) 462-2044
(435) 462-2043
Mailing address
1055 N 500 W ATTN: CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9144918-1206
UT
363AM0700X
Medical Physician Assistant
9144918-8906
UT
Other
Enumeration date
10/30/2012
Last updated
11/27/2023
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