Provider Demographics
NPI:1629759501
Name:STEPHENS, ADAM (PA)
Entity type:Individual
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First Name:ADAM
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:101 PARK PL
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-6764
Mailing Address - Country:US
Mailing Address - Phone:334-877-1490
Mailing Address - Fax:334-877-1491
Practice Address - Street 1:2210 HIGHWAY 221
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AL
Practice Address - Zip Code:36726-4233
Practice Address - Country:US
Practice Address - Phone:334-682-5772
Practice Address - Fax:334-682-5792
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2024-05-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant