Provider Demographics
NPI:1346679388
Name:PATYK, STEPHANIE (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:PATYK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 N MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-3274
Mailing Address - Country:US
Mailing Address - Phone:870-674-6117
Mailing Address - Fax:870-672-6823
Practice Address - Street 1:1609 N MEDICAL DRIVE
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160
Practice Address - Country:US
Practice Address - Phone:870-674-6117
Practice Address - Fax:870-672-6376
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE9812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine