Dr. Charles Gordon Stevenson III
Optometrist
770 Hwy 331 South Suite 1
DeFuniak Springs
, Florida 32435
Dr. Charles Gordon Stevenson III
Optometrist
770 Hwy 331 South Suite 1
DeFuniak Springs
, Florida 32435
(850) 892-0189
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Charles Gordon Stevenson III
- Po Box 1289
- Defuniak Springs, FL
- Zip : 32435
- Fax : (850) 892-0189
- Phone : (850) 892-5514
Second Address
- Dr. Charles Gordon Stevenson III
- 770 Hwy 331 South Suite 1
- Defuniak Springs, FL
- Zip : 32435
- Fax : (850) 892-0189
- Phone : (850) 892-5514
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OP0002311 | FL |
National Provider Identifier
| NPI | 1003999756 |
|---|---|
| Provider Name | Dr. Charles Gordon Stevenson III |
| First Address | Defuniak Springs, FL 32435 |
| Second Address | Defuniak Springs, FL 32435 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/10/2006 |
| Last Update Date | 25/09/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 084170600 | (05) | FL |
| U01013 | (02) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.