Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 61-3757 | TN |
NPI | 1003957663 |
---|---|
Provider Name | William Rc Stewart III |
First Address | Franklin, TN 37067-4606 |
Second Address | Franklin, TN 37067-4606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 18/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E67978 | (02) |