Provider Demographics
NPI:1942759287
Name:STEPHANY, CHRISTOPHER STEVEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:STEVEN
Last Name:STEPHANY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 BALDWIN RD
Mailing Address - Street 2:
Mailing Address - City:OCHLOCKNEE
Mailing Address - State:GA
Mailing Address - Zip Code:31773-1805
Mailing Address - Country:US
Mailing Address - Phone:904-382-0847
Mailing Address - Fax:
Practice Address - Street 1:3200 N ASHLEY ST STE C
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-5911
Practice Address - Country:US
Practice Address - Phone:229-671-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8454363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant