Provider Demographics
NPI:1013921162
Name:DILL, STEPHEN REEVES (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:REEVES
Last Name:DILL
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 1:6801 AIRPORT BLVD 11TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3709
Mailing Address - Country:US
Mailing Address - Phone:251-445-2412
Mailing Address - Fax:850-981-1878
Practice Address - Street 1:6801 AIRPORT BLVD # 11N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3709
Practice Address - Country:US
Practice Address - Phone:251-445-2412
Practice Address - Fax:850-981-1878
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD12041207R00000X
AL00012041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51093021OtherBLUE CROSS BLUE SHIELD AL
AL5285145OtherAETNA
AL000093021Medicaid
AL157220Medicaid
ALC73276Medicare UPIN
AL000093021Medicare ID - Type Unspecified