Provider Demographics
NPI:1588826903
Name:HO, STEPHANIE ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANNE
Last Name:HO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1267 N STEAMBOAT DR STE 3
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-7148
Mailing Address - Country:US
Mailing Address - Phone:479-316-6565
Mailing Address - Fax:479-316-0331
Practice Address - Street 1:1267 N STEAMBOAT DR STE 3
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-7148
Practice Address - Country:US
Practice Address - Phone:479-316-6565
Practice Address - Fax:479-316-0331
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-6359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200882200AMedicaid
AR185211001Medicaid
OK200232000AMedicaid