Provider Demographics
NPI:1780829572
Name:STEVENS, DAVID LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LYNN
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 OLD JONESBORO RD.
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37621-7500
Mailing Address - Country:US
Mailing Address - Phone:423-844-1000
Mailing Address - Fax:423-844-1017
Practice Address - Street 1:504 OLD JONESBORO RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-5670
Practice Address - Country:US
Practice Address - Phone:423-844-1000
Practice Address - Fax:423-844-1017
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine