Mary Lee Stephens in Broken Arrow - Pediatrics
Mary Lee Stephens - NPI 1205045812
Mary Lee Stephens is a Pediatrics in Broken Arrow, Oklahoma. Mary Lee Stephens practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Mary Lee Stephens is 1205045812. The last update date is 2007-07-08.
Mary Lee Stephens's current location address is 11933 E 126th St, Broken Arrow, Oklahoma. You can contact this provider via phone number 9183693008. The mailing address for Mary Lee Stephens is 11933 E 126th St, Broken Arrow, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Lee Stephens |
|---|---|
| Address | 11933 E 126th St, Broken Arrow, Oklahoma |
| Phone Number | 9183693008 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PT |
NPI Number Detail
| NPI Number | 1205045812 |
|---|---|
| Provider Enumeration Date | 2007-05-21 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 11933 E 126th St |
|---|---|
| City | Broken Arrow |
| State | Oklahoma (OK) |
| Post Code | 740115230 |
| Phone Number | 9183693008 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 2251P0200X |
| Licence No | PT650 |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, |
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What is the unique identification code assigned to Mary Lee Stephens by the Centers for Medicare & Medicaid Services?
The Mary Lee Stephens has been issued the NPI (National Provider Identifier) 1205045812. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Mary Lee Stephens is physically located?
The Mary Lee Stephens is situated at the following address: 11933 E 126Th St, Broken Arrow, OK 740115230.
What is Mary Lee Stephens's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Mary Lee Stephens is Pediatrics, and the taxonomy code that classifies this field of practice is 2251P0200X.
On what date did the Centers for Medicare & Medicaid Services issue the 1205045812 to Mary Lee Stephens?
The Mary Lee Stephens received its 1205045812 assignment from the Centers for Medicare & Medicaid Services on 2007-05-21.
As of what date were the details related to Mary Lee Stephens most recently updated or revised?
The information pertaining to Mary Lee Stephens, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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