Provider Demographics
NPI:1497019491
Name:WAYNE A STEPHENS II
Entity type:Organization
Organization Name:WAYNE A STEPHENS II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:256-325-1717
Mailing Address - Street 1:9059 MADISON BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3109
Mailing Address - Country:US
Mailing Address - Phone:256-325-1717
Mailing Address - Fax:256-325-1718
Practice Address - Street 1:9059 MADISON BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3109
Practice Address - Country:US
Practice Address - Phone:256-325-1717
Practice Address - Fax:256-325-1718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2195111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty