Todd Stephenson, DMD

Individual provider Active NPI General Practice Physician · Burkesville, KY

NPI 1992820013 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992820013
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
5460 (KY)
Practice address
405 North Main Street
Burkesville, KY 42717
Phone
(270) 864-3465
Fax
(270) 864-3496
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5460KYMDGeneral Practice Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5460 KY Yes

Addresses

Primary practice location

405 North Main Street
Burkesville, KY 42717

Mailing address

PO Box 376
Burkesville, KY 42717-0376
Phone (270) 864-3465

Other providers in Burkesville, KY

All providers in Burkesville, KY · General Practice Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.