Individual
ALLAN M. STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 N BROAD ST NE, SUITE 220, ROME, GA 30161-5207
(706) 291-2077
(706) 235-4177
Mailing address
PO BOX 369, ROME, GA 30162-0369
(706) 291-2077
(706) 235-4177
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
021824
GA
2085N0700X
Neuroradiology Physician
021824
GA
2085N0904X
Nuclear Radiology Physician
021824
GA
2085P0229X
Pediatric Radiology Physician
021824
GA
2085R0202X
Diagnostic Radiology Physician
Primary
021824
GA
2085R0203X
Therapeutic Radiology Physician
021824
GA
2085R0204X
Vascular & Interventional Radiology Physician
021824
GA
2085U0001X
Diagnostic Ultrasound Physician
021824
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000285249D
—
GA
01
—
300124683
RAILROAD MEDICARE
GA
01
—
593805
BCBS OF GEORGIA
GA
Enumeration date
12/12/2006
Last updated
07/25/2012
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