Provider Demographics
NPI:1962514612
Name:STEPHENS, RONALD JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JAMES
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:MORGANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1833 BOULEVARD
Mailing Address - Street 2:VETERANS AFFAIRS MEDICAL CLINIC
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-4382
Mailing Address - Country:US
Mailing Address - Phone:904-232-2751
Mailing Address - Fax:904-301-2503
Practice Address - Street 1:1833 BOULEVARD
Practice Address - Street 2:VETERANS AFFAIRS MEDICAL CLINIC
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-4382
Practice Address - Country:US
Practice Address - Phone:904-232-2751
Practice Address - Fax:904-301-2503
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMEOO29142207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine