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NPI 1851490551

NPI 1851490551 : BARRY A STEWART MD : LA FOLLETTE, TN

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General NPI Number Information
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    NPI Number           |    1851490551
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    Entity Type          |    Individual 
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    Provider Name        |    BARRY A STEWART MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/21/2006
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    Last Update Date     |    02/08/2008
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Provider Practice Location Address
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    Address Line         |    923 E CENTRAL AVE 
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    City                 |    LA FOLLETTE
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    State                |    TN
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    Zip                  |    37766-2768
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    Country              |    US
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    Telephone            |    423-907-1404
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 636019 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45263-6019
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    Country              |    US
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    Telephone            |    800-577-7707
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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        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    18993
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    License Number State |    TN
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