Provider Demographics
NPI:1083146880
Name:STEPHENS, JOSEPH DALLIS (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DALLIS
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-0236
Mailing Address - Country:US
Mailing Address - Phone:812-933-5441
Mailing Address - Fax:812-933-3766
Practice Address - Street 1:26 SIX PINE RANCH RD
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-1399
Practice Address - Country:US
Practice Address - Phone:812-933-3765
Practice Address - Fax:812-933-3766
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.015738207X00000X
IN02007189A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery