Healthcare Provider Details

I. General information

NPI: 1891958997
Provider Name (Legal Business Name): JULIE ANN STEWART MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE ANN GRIFFIN MD

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E WASHINGTON ST
ARMA KS
66712-4001
US

IV. Provider business mailing address

3011 N MICHIGAN ST
PITTSBURG KS
66762-2546
US

V. Phone/Fax

Practice location:
  • Phone: 620-347-4033
  • Fax:
Mailing address:
  • Phone: 620-231-9873
  • Fax: 620-231-2808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04.34309
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04.34309
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: