Provider Demographics
NPI:1659344117
Name:STEPHENS, ANTHONY W (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:W
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3089
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47730-3089
Mailing Address - Country:US
Mailing Address - Phone:812-471-1200
Mailing Address - Fax:812-475-6700
Practice Address - Street 1:3699 EPWORTH RD
Practice Address - Street 2:SUITE 110
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8909
Practice Address - Country:US
Practice Address - Phone:812-471-1200
Practice Address - Fax:812-475-6700
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040406A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200035800Medicaid
IN194870Medicare PIN