Organization
JAMES B DESTEPHENS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES BRUCE DESTEPHENS MD (MD)
(352) 371-1804
Entity
Organization
Contact information
Practice address
2341 NW 41ST ST STE B, GAINESVILLE, FL 32606-7442
(352) 371-1804
(352) 371-2033
Mailing address
2341 NW 41ST ST STE B, GAINESVILLE, FL 32606-7442
(352) 371-1804
(352) 371-2033
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME0045204
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175709
BLACK LUNG
FL
01
—
1982684460
NPI ATTACHED TO SS NO
FL
Enumeration date
02/17/2007
Last updated
08/22/2020
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