Individual
KYLE STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 852-1895
Mailing address
457 COLONIAL AVE SW, LOS LUNAS, NM 87031-8581
(505) 480-5125
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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