Healthcare Provider Details

I. General information

NPI: 1174796510
Provider Name (Legal Business Name): STEWART MONES, MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 OAKLEIGH LN
EUGENE OR
97404
US

IV. Provider business mailing address

90 OAKLEIGH LN
EUGENE OR
97404
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License NumberMD21303
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD21303
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD21303
License Number StateOR

VIII. Authorized Official

Name: STEWART L MONES
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 541-914-5035