Provider Demographics
NPI:1356373583
Name:BLACKSTOCK, STEPHEN FEW (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:FEW
Last Name:BLACKSTOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 MEDICAL CENTER DR
Mailing Address - Street 2:STE 501
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1158
Mailing Address - Country:US
Mailing Address - Phone:256-492-2663
Mailing Address - Fax:256-492-8620
Practice Address - Street 1:300 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1157
Practice Address - Country:US
Practice Address - Phone:256-492-2663
Practice Address - Fax:256-492-8620
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL19922207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051520468OtherBLUE CROSS/BLUE SHIELD
AL051520468Medicaid
ALG26990Medicare UPIN
051520468Medicare ID - Type Unspecified