Healthcare Provider Details

I. General information

NPI: 1144277559
Provider Name (Legal Business Name): STEWART L MONES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 OAKLEIGH LN
EUGENE OR
97404-3226
US

IV. Provider business mailing address

90 OAKLEIGH LN
EUGENE OR
97404-3226
US

V. Phone/Fax

Practice location:
  • Phone: 541-653-9700
  • Fax: 541-607-5593
Mailing address:
  • Phone: 541-653-9700
  • Fax: 541-653-9715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD21303
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD21303
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: