Provider Demographics
NPI:1275506917
Name:KINSEY, STEVEN W (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:KINSEY
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 1:1711 N MCKENZIE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-2282
Mailing Address - Country:US
Mailing Address - Phone:251-424-1620
Mailing Address - Fax:251-962-6620
Practice Address - Street 1:1711 N MCKENZIE ST STE 201
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2282
Practice Address - Country:US
Practice Address - Phone:251-952-6597
Practice Address - Fax:251-952-6620
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26920208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL255112Medicaid
AL254731Medicaid