Stephen M Pullen PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

STEPHEN M PULLEN PA

Practice address

11808-1 San Jose Blvd
Jacksonville, FL 32223

Phone

(904) 262-2249

Fax

(904) 268-8283

NPI assigned

Apr 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Stephen McAfee Pullen, OD

Title

Owner Optometrist

Phone

(904) 262-2249

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1568428795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11808-1 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-262-2249",
            "fax_number": "904-268-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11808-1 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-262-2249",
            "fax_number": "904-268-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN M PULLEN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "PULLEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "MCAFEE",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "904-262-2249",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "74964",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brian Layne Stephens, MD
• Detoshia Aftan Stephens, MS
• Jamara Stephens
• Katrenia Lashawn Stephens
• Kristen Marie Stephens, COTA

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.