Edstrom, Stephen Blackstone
Edstrom, Stephen Blackstone is an individual health care provider with primary practice located at 1100 Wilford Hall Loop Bldg 4554 , Jbsa Lackland TX 78236-5638. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Edstrom, Stephen Blackstone can be contacted via phone (210) 292-6255.Contact Information
Primary practice address
1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland TX 78236-5638
Phone: (210) 292-6255
Fax: (210) 292-7934
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01066091A | Indiana |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 35.151601 | Ohio |
Profile Details
| NPI number | 1396942264 |
|---|---|
| LBN Legal business name | Edstrom, Stephen Blackstone |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2007 |
| Last updated | Jun 6th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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