Provider Demographics
NPI:1184610800
Name:STEVENSON, TERRY KULIA (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:KULIA
Last Name:STEVENSON
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:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2329
Mailing Address - Country:US
Mailing Address - Phone:928-345-2150
Mailing Address - Fax:928-345-2151
Practice Address - Street 1:2503 S AVENUE A STE 2
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7174
Practice Address - Country:US
Practice Address - Phone:928-783-0092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7725207Q00000X, 2083A0100X
AZ585832083A0100X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine