Provider Demographics
NPI:1538188313
Name:STUARD, JAMES H (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:STUARD
Suffix:
Gender:M
Credentials:DMD
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 953
Mailing Address - Street 2:
Mailing Address - City:MAGEE
Mailing Address - State:MS
Mailing Address - Zip Code:39111-0953
Mailing Address - Country:US
Mailing Address - Phone:601-849-0225
Mailing Address - Fax:601-849-0227
Practice Address - Street 1:1667 HWY 49 SUITE 6
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111
Practice Address - Country:US
Practice Address - Phone:601-849-0225
Practice Address - Fax:601-849-0227
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1951-81122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00064884Medicaid