Provider Demographics
NPI:1316989072
Name:ABBEY, STEWART L (OD)
Entity type:Individual
Prefix:DR
First Name:STEWART
Middle Name:L
Last Name:ABBEY
Suffix:
Gender:M
Credentials:OD
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 959
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-0959
Mailing Address - Country:US
Mailing Address - Phone:620-442-1111
Mailing Address - Fax:620-442-2628
Practice Address - Street 1:520 N SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005
Practice Address - Country:US
Practice Address - Phone:620-442-1111
Practice Address - Fax:620-442-2628
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS09433152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100089600AMedicaid
KS005010001OtherMEDICARE
410014269OtherRAILROAD MEDICARE
KS100089600AMedicaid