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NPI 1104617364

NPI 1104617364 : DANIEL JACKSON STUART DPT : HAZEL GREEN, AL

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General NPI Number Information
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    NPI Number           |    1104617364
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    Entity Type          |    Individual 
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    Provider Name        |    DANIEL JACKSON STUART DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/15/2025
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    Last Update Date     |    08/07/2025
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Provider Practice Location Address
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    Address Line         |    13596 HIGHWAY 231 431 N STE 2 
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    City                 |    HAZEL GREEN
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    State                |    AL
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    Zip                  |    35750-8618
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    Country              |    US
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    Telephone            |    256-828-0312
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    927 FRANKLIN ST SE 
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    City                 |    HUNTSVILLE
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    State                |    AL
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    Zip                  |    35801-4306
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    Country              |    US
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    Telephone            |    256-539-2728
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    2-1458
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    License Number State |    AL
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PTH12401
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    License Number State |    AL
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