Healthcare Provider Details

I. General information

NPI: 1447220926
Provider Name (Legal Business Name): JOHN S STEWART D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 GOVERNORS DR NW UNIT 200
HUNTSVILLE AL
35805-3586
US

IV. Provider business mailing address

3810 GOVERNORS DR NW UNIT 200
HUNTSVILLE AL
35805-3586
US

V. Phone/Fax

Practice location:
  • Phone: 256-530-0101
  • Fax: 256-530-0105
Mailing address:
  • Phone: 256-530-0101
  • Fax: 256-530-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number008415
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number18626
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number18626
License Number StateMS
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberDO.3936
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: