Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 008415 | AZ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 18626 | MS |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 18626 | MS |
NPI | 1447220926 |
---|---|
Provider Name | Dr. John S Stewart |
First Address | Scottsdale, AZ 85260-1504 |
Second Address | Scottsdale, AZ 85260-1504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05909019 | (05) | MS |
287289 | MEDICARE- OTHER UNSPECIFIED (01) | MS |
H77154 | (02) | MS |