Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | OP00001601 | WA |
NPI | 1053307298 |
---|---|
Provider Name | Dr. Stephen Patrick Anthony |
First Address | Dallas, TX 75391-1230 |
Second Address | Spokane, WA 99218-8202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2005 |
Last Update Date | 17/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000010143048 | BLUE SHIELD OF IDAHO (01) | |
121591 | LABOR & INDUSTRIES (01) | WA |
5337010 | AETNA (01) | |
805167400 | (05) | ID |
8226334 | (05) | WA |
83004753 | RAILROAD MEDICARE (01) | TX |
AN7110 | ASURIS NW HEALTH (01) | |
F98971 | (02) | |
KF781 | BLUE CROSS OF IDAHO (01) |