Organization
STEPHEN F. KITCHEN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN FREDRICK KITCHEN M.D. (PRESIDENT)
(912) 265-0492
Entity
Organization
Contact information
Practice address
3226 HAMPTON AVE STE B, BRUNSWICK, GA 31520-4257
(912) 265-0492
(912) 265-1091
Mailing address
3226 HAMPTON AVE STE B, BRUNSWICK, GA 31520-4257
(912) 265-0492
(912) 265-1091
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
039839
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000665035B
—
GA
01
—
020036094
RAIL ROAD MEDICARE
GA
01
—
52575527
BLUE CROSS BLUE SHIELD
GA
Enumeration date
12/20/2007
Last updated
10/28/2020
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