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General NPI Number Information
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NPI Number | 1316252521
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Entity Type | Organization
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Legal Business Name | JAMES C STEWART PHD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 2020 BRAMBLWOOD LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1588
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Country | US
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Telephone | 719-244-5652
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 BRAMBLWOOD LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1588
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Country | US
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Telephone | 719-244-5652
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES CHRISTOPHER STEWART
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Credential | PHD
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Telephone | 719-244-5652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 1696
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License Number State | CO
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