Provider Demographics
NPI:1831176981
Name:RECTOR, STEVEN J (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:RECTOR
Suffix:
Gender:
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 657
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-0657
Mailing Address - Country:US
Mailing Address - Phone:706-754-3113
Mailing Address - Fax:706-754-3518
Practice Address - Street 1:541 441 HISTORIC HWY N
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-4528
Practice Address - Country:US
Practice Address - Phone:706-754-3113
Practice Address - Fax:706-754-3518
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044066207P00000X
IAMD-25600207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00855962JMedicaid
GA93BDPZGMedicare ID - Type Unspecified
GA00855962JMedicaid