Individual
MR. DAVID SPENCER STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
504 W BROADWAY ST, HENRYETTA, OK 74437-5214
(918) 650-9500
(918) 650-9559
Mailing address
16107 RIM RD., NONE, EDMOND, OK 73013
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NO OTHER NUMBER KNOW
NO OTHER NUMBER KNOWN
OK
Enumeration date
11/03/2011
Last updated
11/03/2011
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