Provider Demographics
NPI:1376551283
Name:STEPHENS, JOHN CARL JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CARL
Last Name:STEPHENS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-2606
Mailing Address - Country:US
Mailing Address - Phone:334-382-6343
Mailing Address - Fax:334-382-7907
Practice Address - Street 1:202 CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-2606
Practice Address - Country:US
Practice Address - Phone:334-382-6343
Practice Address - Fax:334-382-7907
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
51070978OtherBCBS
51070978OtherBCBS