Joe, Stephen W.
Joe, Stephen W. is an individual health care provider with primary practice located at 4824 Goodman Road , Olive Branch MS 38654. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Joe, Stephen W. can be contacted via phone (662) 874-5917.Contact Information
Primary practice address
4824 Goodman Road
Olive Branch MS 38654
Phone: (662) 874-5917
Fax: (662) 874-5998
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 2019-83 | Mississippi |
Profile Details
| NPI number | 1609896729 |
|---|---|
| LBN Legal business name | Joe, Stephen W. |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Sep 14th, 2016 - about 10 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609896729 | NPPES |
| Mississippi | MEDICAID | 00060134 |
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