Clive Stephenson, PA

NPI 1528104817 · on the registry since 2007 · sole proprietor

Practice

Address: 1061 Harmon Ave
Ste 1do3
Ft Stewart, GA 31314
Phone: (912) 435-6933
Fax: (912) 435-5966
Organisation at this address: Wach
Jacer Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 36

Registry record

Primary taxonomy: 363A00000X
363A00000X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia