Provider Demographics
NPI:1538217112
Name:STEPHENSON, JAMES BRYANT (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRYANT
Last Name:STEPHENSON
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 1:81 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-6439
Mailing Address - Country:US
Mailing Address - Phone:610-326-2300
Mailing Address - Fax:610-970-5889
Practice Address - Street 1:81 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-6439
Practice Address - Country:US
Practice Address - Phone:610-326-2300
Practice Address - Fax:610-970-5889
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021269E2083P0500X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01000720Medicaid
PAC28959Medicare UPIN
PAST071488Medicare ID - Type Unspecified