Provider Demographics
NPI:1699477950
Name:STEVENSON, MEGHAN (DO)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10178 BURNT MILL LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6971
Mailing Address - Country:US
Mailing Address - Phone:972-658-7437
Mailing Address - Fax:
Practice Address - Street 1:300 CARSON ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3104
Practice Address - Country:US
Practice Address - Phone:870-910-7799
Practice Address - Fax:870-336-2999
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR207R00000X207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine