Basic Information
| Provider Information | |||||||||
| NPI: | 1265435390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEPHENS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2060 READING RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452021454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137213200 | ||||||||
| FaxNumber: | 5136393186 | ||||||||
| Practice Location | |||||||||
| Address1: | 5885 HARRISON AVE | ||||||||
| Address2: | SUITE 3100 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452481691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139226666 | ||||||||
| FaxNumber: | 5139221812 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 10/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 35.045357 | OH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 988682 | 01 | OH | AETNA | OTHER | 311575051026 | 01 | OH | CARESOURCE | OTHER | 0720506 | 01 | OH | UNITED HEALTCARE | OTHER | 000000021101 | 01 | OH | ANTHEM | OTHER | 160039282 | 01 | OH | MEDICARE RAILROAD | OTHER | 288085 | 01 | OH | AMERIGROUP | OTHER | 0530563 | 01 | OH | HUMANA | OTHER | 0530563 | 05 | OH | MEDICAID |