MEDICARE: DR. STEWART BLAIR TOLAR MD

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	207V00000X	Obstetrics & Gynecology Physician	38529	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811984941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEWART BLAIR TOLAR MD

Provider Business Mailing Address
First Line	:	2605 KENTUCKY AVE
Second Line	:	SUITE 306
City	:	PADUCAH
State	:	KY
Zip	:	42003-3800
Country	:	US
Telephone Number	:	270-415-7653
Fax Number	:	270-575-8359

Provider Business Practice Location Address
First Line	:	2605 KENTUCKY AVE
Second Line	:	SUITE 301
City	:	PADUCAH
State	:	KY
Zip	:	42003-3800
Country	:	US
Telephone Number	:	270-443-1220
Fax Number	:	270-443-0023

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	08/18/2016

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