Provider Demographics
NPI:1811236136
Name:STEPHENS, KEVIN ULYSSE SR (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ULYSSE
Last Name:STEPHENS
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 ROSEDOWN CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-3313
Mailing Address - Country:US
Mailing Address - Phone:504-228-4991
Mailing Address - Fax:504-433-2091
Practice Address - Street 1:1 ROSEDOWN CT
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-3313
Practice Address - Country:US
Practice Address - Phone:504-228-4991
Practice Address - Fax:504-433-2091
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA017769207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics