Organization
J. CRAIG STEVENS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN CRAIG STEVENS M.D. (PRESIDENT)
(800) 613-1580
Entity
Organization
Contact information
Practice address
750 N SYRINGA ST, SUITE 100, POST FALLS, ID 83854-5275
(800) 613-1580
Mailing address
PO BOX 353, CLARK FORK, ID 83811-0353
(208) 266-1677
Taxonomy
Speciality
Code
Description
License number
State
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
7507
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805192200
—
ID
Enumeration date
10/10/2011
Last updated
08/13/2012
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