Provider Demographics
NPI:1104135284
Name:STEWART, KAYLA ASHLEY (OD, MED)
Entity type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:ASHLEY
Last Name:STEWART
Suffix:
Gender:F
Credentials:OD, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 59
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:MT
Mailing Address - Zip Code:59041-0059
Mailing Address - Country:US
Mailing Address - Phone:971-322-6531
Mailing Address - Fax:
Practice Address - Street 1:101 BERNHARDT RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-8702
Practice Address - Country:US
Practice Address - Phone:406-628-1767
Practice Address - Fax:406-628-1769
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1923152W00000X
MTOPT-OPT-LIC-1923152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152W00000XEye and Vision Services ProvidersOptometrist