Provider Demographics
NPI:1356433130
Name:STEPHENS, KARL F (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:F
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4586
Mailing Address - Country:US
Mailing Address - Phone:401-245-1775
Mailing Address - Fax:401-245-1775
Practice Address - Street 1:147 COUNTY RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-4586
Practice Address - Country:US
Practice Address - Phone:401-245-1775
Practice Address - Fax:401-245-1775
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI3946207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI3946OtherEYEMED
6365OtherBCBSRI
RI9000636Medicaid
RI9000636Medicaid