Provider Demographics
NPI:1699786921
Name:STEWART, DWIGHT K (DC)
Entity type:Individual
Prefix:
First Name:DWIGHT
Middle Name:K
Last Name:STEWART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2316
Mailing Address - Country:US
Mailing Address - Phone:501-223-3314
Mailing Address - Fax:501-223-8023
Practice Address - Street 1:8801 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2316
Practice Address - Country:US
Practice Address - Phone:501-223-3314
Practice Address - Fax:501-223-8023
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59704OtherBLUE CROSS AND BLU SHIELD
AR59704Medicare ID - Type Unspecified
AR59704OtherBLUE CROSS AND BLU SHIELD