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Individual

STEVENS D MELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1700 WOODLAWN AVE, DYERSBURG, TN 38024
(731) 287-4500
(731) 287-4804
Mailing address
1700 WOODLAWN AVE, DYERSBURG, TN 38024
(731) 287-4500
(731) 287-4804

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14213
TN
208000000X
Pediatrics Physician
Primary
MD014213
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0052428
BLUE CROSS
01
116249
BETTER HEALTH PLAN
01
1240124
UNITED HEALTH CARE
05
3015669
TN
01
370008023
PALMETTO GBA
01
4176802
BCBS
TN
01
4673227
AETNA
01
7161
TLC (MEMPHIS MANAGED CARE
01
8203648
CIGNA
Enumeration date
09/09/2005
Last updated
01/20/2015
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