Provider Demographics
NPI:1578535399
Name:STEPHENS, JEFFERY NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:NELSON
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2865 N REYNOLDS RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2068
Mailing Address - Country:US
Mailing Address - Phone:419-578-2020
Mailing Address - Fax:419-539-6323
Practice Address - Street 1:2865 N REYNOLDS RD
Practice Address - Street 2:SUITE 170
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-2068
Practice Address - Country:US
Practice Address - Phone:419-578-2020
Practice Address - Fax:419-539-6323
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086319207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH118130001OtherADMINASTAR
OHP00264763OtherFAMILY HEALTH PLAN
OH2603687Medicaid
OH04789OtherPARAMOUNT
OH7008492OtherAETNA
OH000000372906OtherANTHEM
OH4163021Medicare PIN
OH4163022Medicare PIN
OHP00264763OtherFAMILY HEALTH PLAN
OH000000372906OtherANTHEM
OHP00264783Medicare PIN