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Individual

JAMES H. STEVENS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1026 MAR WALT DR, FT WALTON BEACH, FL 32547-6645
(850) 863-5294
(850) 864-1648
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME0068163
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009913035
AL. MCAID PSO PROVIDER #
AL
01
009913045
AL. MCAID FWB PROVIDER #
AL
01
009913055
AL. MCAID CRO PROV. #
AL
01
009948615
AL. MCAID SRB PROVIDER #
AL
01
1179761
WELLCARE
FL
05
118454 (CRO)
AL
05
118458 (FWB)
AL
05
118469 (DSF)
AL
05
118471 (SRB)
AL
01
16-01523
UTD. HLTHCR. PROVIDER #
FL
01
212959
AVMED
FL
05
377888600
FL
01
5120028
AETNA PROVIDER NUMBER
FL
01
8870766-006
CIGNA PROVIDER NUMBER
FL
Enumeration date
09/14/2005
Last updated
05/06/2016
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