Provider Demographics
NPI:1134170806
Name:STEVENS, RICK BRIAN (MD)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:BRIAN
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:988095 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8095
Mailing Address - Country:US
Mailing Address - Phone:402-559-9800
Mailing Address - Fax:402-559-9840
Practice Address - Street 1:5149 N 9TH AVE STE 246
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8755
Practice Address - Country:US
Practice Address - Phone:850-416-1080
Practice Address - Fax:850-416-1075
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL125474204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015723600Medicaid
NE47078557580Medicaid
FL015723600Medicaid
FLIH848ZMedicare PIN
NE47078557580Medicaid