Individual
TODD RUSSELL STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3285
Mailing address
4200 UNIVERSITY AVE, SUITE 104, WEST DES MOINES, IA 50266-5945
(515) 226-7426
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
3492
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0284703
—
IA
01
—
34129
BCBS OF IOWA
—
01
—
34130
BCBS OF IOWA
—
05
—
7706150
—
SD
01
—
P00013853
RAILROAD MEDICARE
—
Enumeration date
03/23/2006
Last updated
09/17/2013
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