Individual
DR. AMY M STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
15196 US HIGHWAY 19 S, THOMASVILLE, GA 31757-4820
(229) 228-4770
(229) 225-9060
Mailing address
1950 OLD GALLOWS RD, STE 520, VIENNA, VA 22182-3970
(850) 893-4005
(850) 894-5462
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
001621
GA
152W00000X
Optometrist
OPC3179
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00825833A
—
GA
01
—
20842
BLUR CROSS BLUE SHIELD
FL
01
—
410037564
RAILROAD MEDICARE
FL
05
—
620388400
—
FL
Enumeration date
12/12/2006
Last updated
02/16/2018
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