Healthcare Provider Details

I. General information

NPI: 1013908557
Provider Name (Legal Business Name): JANE E STEWART D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8929 PARALLEL PKWY
KANSAS CITY KS
66112-1689
US

IV. Provider business mailing address

10540 MARTY ST STE 100
OVERLAND PARK KS
66212-2551
US

V. Phone/Fax

Practice location:
  • Phone: 913-660-1616
  • Fax: 913-660-1664
Mailing address:
  • Phone: 913-660-1616
  • Fax: 913-660-1664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2013043105
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05-31090
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: