Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 8265 | IN |
NPI | 1073658456 |
---|---|
Provider Name | Dr. Richard J Stuart JR. |
First Address | Indianapolis, IN 46236-8896 |
Second Address | Indianapolis, IN 46280-2938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 11/02/2015 |