Individual
THOMAS C STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 E CHESTNUT ST # 5B, LOUISVILLE, KY 40202-1713
(502) 588-2330
(502) 588-9513
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5754
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27381
KY
208000000X
Pediatrics Physician
27381
KY
2080P0206X
Pediatric Gastroenterology Physician
Primary
27381
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100374710
—
IN
05
—
64273816
—
KY
05
—
6427381600
—
KY
Enumeration date
11/29/2005
Last updated
03/16/2020
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