Individual
JOHN ALBERT STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 S MAIN ST, SUITE 100, CLINTON, IN 47842-2493
(765) 828-1003
(765) 828-1030
Mailing address
PO BOX 344, CLINTON, IN 47842-0344
(765) 828-1003
(765) 828-1030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01043105
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080141873
RR MEDICARE
IN
05
—
200038350
—
IN
Enumeration date
11/02/2005
Last updated
03/18/2011
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