Provider Demographics
NPI:1699954172
Name:IRWIN, STEPHEN ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALEXANDER
Last Name:IRWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9330 LBJ FWY STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4310
Mailing Address - Country:US
Mailing Address - Phone:972-792-5700
Mailing Address - Fax:214-506-1170
Practice Address - Street 1:2068 HAWTHORNE ST STE 101
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2368
Practice Address - Country:US
Practice Address - Phone:941-362-5555
Practice Address - Fax:941-362-5559
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME98838208VP0014X
ARE-6777208VP0000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME98838OtherDEPARTMENT OF HEALTH