Organization
STEPHENS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL L STEPHENS M.D. (OWNER)
(706) 863-7021
Entity
Organization
Contact information
Practice address
1109 MEDICAL CENTER DR, SUITE 8A, AUGUSTA, GA 30909-6633
(706) 863-7021
(706) 651-6322
Mailing address
1109 MEDICAL CENTER DR, SUITE 8A, AUGUSTA, GA 30909-6633
(706) 863-7021
(706) 651-6322
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
040246
GA
Other
Enumeration date
07/06/2007
Last updated
01/22/2013
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