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Individual

SCOTT MATTHEW STEPHENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
110 HARDIN LN, SUITE 10, SOMERSET, KY 42503-3818
(606) 679-9268
(606) 677-1020
Mailing address
110 HARDIN LN, SUITE 10, SOMERSET, KY 42503-3818
(606) 679-9268
(606) 677-1020

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29795
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29795
KENTUCKY LICENSE
KY
01
61,1355693
TAX ID
05
64297955
KY
Enumeration date
07/26/2006
Last updated
05/12/2011
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