Stephens, Timothy Shawn
Stephens, Timothy Shawn is an sole proprietor health care provider with primary practice located at 244 Grand Central Mall , Vienna WV 26101-1105. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Stephens, Timothy Shawn can be contacted via phone (304) 485-1199.Contact Information
Primary practice address
244 Grand Central Mall
Vienna WV 26101-1105
Phone: (304) 485-1199
Fax: (304) 428-8102
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1004OS | West Virginia |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5261T2167 | Ohio |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2282 | Tennessee |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1533DT | Kentucky |
Profile Details
| NPI number | 1619979630 |
|---|---|
| LBN Legal business name | Stephens, Timothy Shawn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Mar 25th, 2010 - about 16 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 | 1619979630 | NPPES |
| West Virginia | MEDICAID | 3810001212 |
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