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Individual

JAYNE RYDER STEVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859
(808) 433-3169
Mailing address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-0976

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301111259
MI
208D00000X
General Practice Physician
27671
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
VAD000
MEDICARE UPN
Enumeration date
04/13/2012
Last updated
04/21/2023
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