Provider Demographics
NPI:1316106032
Name:STEPHENS, LATOYA BENITA (MD)
Entity type:Individual
Prefix:DR
First Name:LATOYA
Middle Name:BENITA
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 JEFFERSON PKWY
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-5823
Mailing Address - Country:US
Mailing Address - Phone:770-683-9136
Mailing Address - Fax:770-683-9148
Practice Address - Street 1:175 JEFFERSON PKWY
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-5823
Practice Address - Country:US
Practice Address - Phone:770-683-9136
Practice Address - Fax:770-683-9148
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058512207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology