Provider Demographics
NPI:1750360509
Name:STEPHENS, JAMES DEWEY (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DEWEY
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7357 E GOODALL RD
Mailing Address - Street 2:
Mailing Address - City:DURAND
Mailing Address - State:MI
Mailing Address - Zip Code:48429-9732
Mailing Address - Country:US
Mailing Address - Phone:989-277-7128
Mailing Address - Fax:
Practice Address - Street 1:7357 E GOODALL RD
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:MI
Practice Address - Zip Code:48429-9732
Practice Address - Country:US
Practice Address - Phone:989-277-7127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist