Provider Demographics
NPI:1114154960
Name:STEVENS, JOSHUA ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALAN
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NW 6TH ST
Mailing Address - Street 2:STE 150
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-2823
Mailing Address - Country:US
Mailing Address - Phone:405-609-8700
Mailing Address - Fax:
Practice Address - Street 1:301 NW 6TH ST
Practice Address - Street 2:STE 150
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-2823
Practice Address - Country:US
Practice Address - Phone:405-609-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27377208D00000X
KS04-40613208D00000X
MO2019014750208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice