Provider Demographics
NPI:1508386913
Name:ANDERSON, STEPHEN K (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:K
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2225
Mailing Address - Fax:614-293-8557
Practice Address - Street 1:543 TAYLOR AVE FL 1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1278
Practice Address - Country:US
Practice Address - Phone:614-293-2225
Practice Address - Fax:614-293-8557
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.1426712081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine