Tedder, Stephen D
Tedder, Stephen D is an individual health care provider with primary practice located at 6001 Professional Pkwy Suite 2040, Douglasville GA 30134-5632. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Tedder, Stephen D can be contacted via phone (678) 838-9999.Contact Information
Primary practice address
6001 Professional Pkwy Suite 2040
Douglasville GA 30134-5632
Phone: (678) 838-9999
Fax: (678) 838-9474
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | ME71025 | Florida |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 049112 | Georgia |
Profile Details
| NPI number | 1093711186 |
|---|---|
| LBN Legal business name | Tedder, Stephen D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Jun 13th, 2017 - about 7 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 | 1093711186 | NPPES |
| Georgia | Other | 08-01712 | EVERCARE |
| Georgia | Other | 324017 | EVERCARE |
| Georgia | Other | P00239339 | EVERCARE |
| Georgia | MEDICAID | 000719155J | EVERCARE |
| Georgia | Other | 4299075 | EVERCARE |
| Georgia | Other | 930413 | EVERCARE |
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