Provider Demographics
NPI:1043999626
Name:STEPHENS, PAUL LAMONT
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:LAMONT
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N LOTTIE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-2051
Mailing Address - Country:US
Mailing Address - Phone:405-600-3074
Mailing Address - Fax:
Practice Address - Street 1:1311 N LOTTIE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-2051
Practice Address - Country:US
Practice Address - Phone:405-600-3074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist