Stephen Allen Modelevsky
Oral and Maxillofacial Pathology
906 Osler Drive
Jonesboro
, Arkansas 72401
Stephen Allen Modelevsky
Oral and Maxillofacial Pathology
906 Osler Drive
Jonesboro
, Arkansas 72401
(870) 972-5451
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Stephen Allen Modelevsky
- Po Box 1920
- Jonesboro, AR
- Zip : 72403
- Fax : (870) 972-5451
- Phone : (870) 972-8570
Second Address
- Stephen Allen Modelevsky
- 906 Osler Drive
- Jonesboro, AR
- Zip : 72401
- Fax : (870) 972-5451
- Phone : (870) 972-8570
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 2302 | AR |
National Provider Identifier
| NPI | 1477647089 |
|---|---|
| Provider Name | Stephen Allen Modelevsky |
| First Address | Jonesboro, AR 72403 |
| Second Address | Jonesboro, AR 72401 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T20486 | (02) | AR |
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.