Individual
STEPHEN WELLS ALCORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10192 N NATCHEZ LOOP, DUNNELLON, FL 34434-3747
(352) 522-0225
Mailing address
12109 CR 103, OXFORD, FL 34484-2967
(352) 391-6494
(352) 391-6498
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
5032
SD
208800000X
Urology Physician
Primary
ME25975
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065337300
—
FL
01
—
09022
BCBS
FL
Enumeration date
10/29/2006
Last updated
06/08/2011
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