Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 1027875 | IN |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 1027875 | IN |
NPI | 1073510889 |
---|---|
Provider Name | Phillip L. Stiver |
First Address | Evansville, IN 47715-8198 |
Second Address | Evansville, IN 47715-8198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000108312 | ANTHEM (01) | IN |
135422 | HEALTHLINK (01) | IN |
D95045 | (02) |