Healthcare Provider Details

I. General information

NPI: 1871541292
Provider Name (Legal Business Name): KEVIN PHILLIP STEWART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 LOCKHART GDN CTR STE 4
ST THOMAS VI
00802-2808
US

IV. Provider business mailing address

PO BOX 910
CHRISTIANSTED VI
00821-0910
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-2015
  • Fax: 340-774-9590
Mailing address:
  • Phone: 340-773-2015
  • Fax: 340-719-9590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number1452
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number226054
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME102455
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: