Organization
OBSTETRICS & GYNECOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN A STEVENS MD (OWNER/PHYSICIAN)
(850) 863-1000
Entity
Organization
Contact information
Practice address
1703 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547-1221
(850) 863-1000
(850) 863-0800
Mailing address
1703 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547-1221
(850) 863-1000
(850) 863-0800
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME84285
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11131
BCBS OF FL
FL
05
—
264593900
—
FL
Enumeration date
08/03/2006
Last updated
03/10/2010
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