Individual
DR. GRANT L STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
211 KY 59, VANCEBURG, KY 41179-9701
(606) 796-3029
(606) 796-6221
Mailing address
PO BOX 550, VANCEBURG, KY 41179-0550
(606) 796-3029
(606) 796-6221
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20174
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0449527
—
OH
05
—
7100001650
—
KY
Enumeration date
02/06/2006
Last updated
06/14/2010
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