Provider Demographics
NPI:1053530675
Name:STEBBINS, TIMOTHY DEWAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DEWAYNE
Last Name:STEBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:744 N CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-2409
Mailing Address - Country:US
Mailing Address - Phone:913-522-5189
Mailing Address - Fax:
Practice Address - Street 1:UMKC SCHOOL OF MEDICINE RESIDENCY PROGRAM, M1-210
Practice Address - Street 2:2411 HOLMES STREET
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2792
Practice Address - Country:US
Practice Address - Phone:816-235-6626
Practice Address - Fax:816-235-6629
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2009011514207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine