Stephens, Bryon J.
Stephens, Bryon J. is an individual health care provider with primary practice located at 7910 W Jefferson Blvd Suite 112, Fort Wayne IN 46804-4159. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Stephens, Bryon J. can be contacted via phone (260) 969-7121.Contact Information
Primary practice address
7910 W Jefferson Blvd Suite 112
Fort Wayne IN 46804-4159
Phone: (260) 969-7121
Fax: (260) 436-4292
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 01040106A | Indiana |
Profile Details
| NPI number | 1639170491 |
|---|---|
| LBN Legal business name | Stephens, Bryon J. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Sep 30th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639170491 | NPPES |
| Ohio | MEDICAID | 0998112 | |
| Ohio | MEDICAID | 100082280 | |
| Ohio | MEDICAID | 103410227 | |
| Ohio | Other | P00919721 |
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