Provider Demographics
NPI:1669772000
Name:PRICE, STEVEN L (SFIDC)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:L
Last Name:PRICE
Suffix:
Gender:M
Credentials:SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 EARL ST
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-7371
Mailing Address - Country:US
Mailing Address - Phone:910-320-0686
Mailing Address - Fax:
Practice Address - Street 1:5415 EARL ST
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-7371
Practice Address - Country:US
Practice Address - Phone:910-320-0686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman