MEDICARE: DR. ZACHARY DAVID STEWART OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT003624	GA

General Provider Information

NPI Number	:	1790279248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZACHARY DAVID STEWART OD

Provider Business Mailing Address
First Line	:	6600 VAN AALST BLVD
Second Line	:
City	:	FORT MOORE
State	:	GA
Zip	:	31905-2102
Country	:	US
Telephone Number	:	706-544-9500
Fax Number	:

Provider Business Practice Location Address
First Line	:	9220 MARNE RD
Second Line	:
City	:	FORT BENNING
State	:	GA
Zip	:	31905-5515
Country	:	US
Telephone Number	:	706-682-3938
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	03/02/2026

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