Provider Demographics
NPI:1811995624
Name:OVERSTREET, STEPHEN KASTOR (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:KASTOR
Last Name:OVERSTREET
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4001 KRESGE WAY
Mailing Address - Street 2:STE 134
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4640
Mailing Address - Country:US
Mailing Address - Phone:502-895-0882
Mailing Address - Fax:502-895-1354
Practice Address - Street 1:4001 KRESGE WAY
Practice Address - Street 2:STE 134
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4640
Practice Address - Country:US
Practice Address - Phone:502-895-0882
Practice Address - Fax:502-895-1354
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2020-12-07
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Provider Licenses
StateLicense IDTaxonomies
KY27421207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64274210Medicaid
KY64274210Medicaid
F28891Medicare UPIN