Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stephen Blackstone Edstrom, MD

Individual provider Family Medicine Physician · NPI 1396942264

Stephen Blackstone Edstrom, MD is a Family Medicine Physician in Jbsa Lackland, Texas. Licensed in Indiana and Ohio. Registered with an NPI since 2007.

Licensed in
IN, OH
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone: (210) 292-6255
Fax: (210) 292-7934
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 35.151601 (OH)
Family Medicine Physician Taxonomy 207Q00000X · Licence 01066091A (IN)

Record details

NPI number1396942264
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 2, 2007
Last updated in NPPESJune 6, 2025
Certification dateJune 6, 2025
Mailing address4481 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5536

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