Healthcare Provider Details

I. General information

NPI: 1538188313
Provider Name (Legal Business Name): JAMES H STUARD DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1667 HWY 49 SUITE 6
MAGEE MS
39111
US

IV. Provider business mailing address

PO BOX 953
MAGEE MS
39111-0953
US

V. Phone/Fax

Practice location:
  • Phone: 601-849-0225
  • Fax: 601-849-0227
Mailing address:
  • Phone: 601-849-0225
  • Fax: 601-849-0227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1951-81
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: