Provider Demographics
NPI:1619932944
Name:ARMISTEAD, STEPHEN H (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:H
Last Name:ARMISTEAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-0097
Mailing Address - Country:US
Mailing Address - Phone:850-763-3635
Mailing Address - Fax:850-763-4448
Practice Address - Street 1:2420 JENKS AVE
Practice Address - Street 2:UNIT 5
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4909
Practice Address - Country:US
Practice Address - Phone:850-763-3635
Practice Address - Fax:850-763-4448
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92110207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272152000Medicaid
FL64058OtherBCBS OF FLORIDA
FL64058OtherBCBS OF FLORIDA
FLH88421Medicare UPIN