Provider Demographics
NPI:1316146327
Name:DR JOHN P STEWART PSC
Entity type:Organization
Organization Name:DR JOHN P STEWART PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:502-227-4821
Mailing Address - Street 1:4200 LAWRENCEBURG RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-8415
Mailing Address - Country:US
Mailing Address - Phone:502-227-4821
Mailing Address - Fax:502-227-3013
Practice Address - Street 1:4200 LAWRENCEBURG RD
Practice Address - Street 2:SUITE A
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-8415
Practice Address - Country:US
Practice Address - Phone:502-227-4821
Practice Address - Fax:502-227-3013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities