Provider Demographics
NPI:1891916680
Name:STEPHEN G SANDERS
Entity Type:Organization
Organization Name:STEPHEN G SANDERS
Other - Org Name:MARION REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIAGNOSTIC RADIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-921-6250
Mailing Address - Street 1:1256 MILITARY STREET SOUTH
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:AL
Mailing Address - Zip Code:35570
Mailing Address - Country:US
Mailing Address - Phone:205-921-6250
Mailing Address - Fax:205-921-6260
Practice Address - Street 1:1256 MILITARY STREET SOUTH
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:AL
Practice Address - Zip Code:35570
Practice Address - Country:US
Practice Address - Phone:205-921-6250
Practice Address - Fax:205-921-6260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00007304174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX ID
AL=========OtherTAX ID