Provider Demographics
NPI:1518673664
Name:STEPHENS, RONALD JOSEPH
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JOSEPH
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 SHELLEY DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-8883
Mailing Address - Country:US
Mailing Address - Phone:304-702-4281
Mailing Address - Fax:
Practice Address - Street 1:3105 SHELLEY DR
Practice Address - Street 2:
Practice Address - City:SOUTH PARK
Practice Address - State:PA
Practice Address - Zip Code:15129-8883
Practice Address - Country:US
Practice Address - Phone:304-702-4281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic