Provider Demographics
NPI:1376528091
Name:STEPHENS, RONALD T (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:T
Last Name:STEPHENS
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:USAG-JAPAN, UNIT 45013
Mailing Address - Street 2:BOX 2643
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338
Mailing Address - Country:JP
Mailing Address - Phone:0118142-869-6476
Mailing Address - Fax:
Practice Address - Street 1:USAG-JAPAN
Practice Address - Street 2:UNIT 45011
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96338
Practice Address - Country:JP
Practice Address - Phone:0118142-869-4546
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041971208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation