Provider Demographics
NPI:1902935083
Name:STEPHEN S ABLE MD PLLC
Entity Type:Organization
Organization Name:STEPHEN S ABLE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ABLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-797-1826
Mailing Address - Street 1:PO BOX 69805
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-0022
Mailing Address - Country:US
Mailing Address - Phone:520-797-1826
Mailing Address - Fax:520-797-6975
Practice Address - Street 1:11115 N LA CANADA DR STE 275
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-9496
Practice Address - Country:US
Practice Address - Phone:520-797-1826
Practice Address - Fax:520-797-6975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ202772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ74546Medicare PIN