Provider Demographics
NPI:1144225798
Name:HUMPHREYS, STEVEN CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CRAIG
Last Name:HUMPHREYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HOSPITAL PL
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7559
Mailing Address - Country:US
Mailing Address - Phone:907-714-5770
Mailing Address - Fax:907-714-3111
Practice Address - Street 1:240 HOSPITAL PL STE 104
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7559
Practice Address - Country:US
Practice Address - Phone:907-145-7707
Practice Address - Fax:907-714-3111
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6826174400000X, 207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1144225798OtherNPI
AKMD9678Medicaid
AKK163773Medicare PIN