Provider Demographics
NPI:1447220926
Name:STEWART, JOHN S (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:STEWART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 GOVERNORS DR NW UNIT 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-3586
Mailing Address - Country:US
Mailing Address - Phone:256-530-0101
Mailing Address - Fax:256-530-0105
Practice Address - Street 1:3810 GOVERNORS DR NW UNIT 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-3586
Practice Address - Country:US
Practice Address - Phone:256-530-0101
Practice Address - Fax:256-530-0105
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008415207Y00000X
MS18626207Y00000X, 207YX0905X
ALDO.3936207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05909019Medicaid
MS287289OtherMEDICARE- OTHER UNSPECIFIED
MS05909019Medicaid