Individual
DR. STEPHEN STIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2000 KENTUCKY AVE, PADUCAH, KY 42003-3202
(270) 444-9011
(270) 444-9902
Mailing address
2000 KENTUCKY AVE, PADUCAH, KY 42003-3202
(270) 444-9011
(270) 444-9902
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
163
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204311
BLUE CROSS BLUE SHIELD ID
KY
01
—
137000
HEALTHLINK PROVIDER ID
KY
01
—
62186125242003A001
WPS TRICARE FOR LIFE
KY
01
—
KY0057841
TRICARE NORTH PROVIDER ID
KY
Enumeration date
02/09/2007
Last updated
07/08/2007
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