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General NPI Number Information
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NPI Number | 1598776866
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Entity Type | Organization
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Legal Business Name | JAMES B. STEWART, JR., M.D., P.C.
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3705 W MEMORIAL RD SUITE 101
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-1512
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Country | US
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Telephone | 405-751-0020
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Fax | 405-751-0009
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Provider Business Mailing Address
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Address Line | 3705 W MEMORIAL RD SUITE 101
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-1512
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Country | US
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Telephone | 405-751-0020
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Fax | 405-751-0009
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES BENTON STEWART JR.
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Credential | M.D., P.C.
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Telephone | 405-751-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 17525
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License Number State | OK
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