Provider Demographics
NPI:1033138748
Name:DENTON, STEPHANIE (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:DENTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 7TH AVE S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-3200
Mailing Address - Country:US
Mailing Address - Phone:205-251-4141
Mailing Address - Fax:205-251-2004
Practice Address - Street 1:2316 7TH AVE S
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3200
Practice Address - Country:US
Practice Address - Phone:205-251-4141
Practice Address - Fax:205-251-2004
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19118208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
511-43112OtherBCBS ALABAMA
AL51510836OtherBLUE CROSS OF ALABAMA
AL009923465Medicaid
AL000034651Medicaid
G16615Medicare UPIN