Individual
DR. ANDY P. STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1513-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052544
BLUE CROSS
KS
01
—
0803320001
DMERC
KS
05
—
100296360A
—
KS
01
—
410049080
TRAVELERS MEDICARE
KS
Enumeration date
10/07/2005
Last updated
08/03/2011
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