Provider Demographics
NPI:1578836599
Name:KAY, STEPHEN DANIEL (PT)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DANIEL
Last Name:KAY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 14TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4458
Mailing Address - Country:US
Mailing Address - Phone:601-917-9680
Mailing Address - Fax:601-917-9651
Practice Address - Street 1:1001 14TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4458
Practice Address - Country:US
Practice Address - Phone:601-917-9680
Practice Address - Fax:601-917-9651
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT4552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04031337Medicaid