Provider Demographics
NPI:1053292813
Name:ELSEY, STEPHEN LEE (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LEE
Last Name:ELSEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 RIDDLE RDG
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-5044
Mailing Address - Country:US
Mailing Address - Phone:423-213-7727
Mailing Address - Fax:
Practice Address - Street 1:980 RIDDLE RDG
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-5044
Practice Address - Country:US
Practice Address - Phone:423-213-7727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant