Provider Demographics
NPI:1073570156
Name:HARAWAY, STUART DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:DEAN
Last Name:HARAWAY
Suffix:
Gender:M
Credentials:MD
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 3528
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72913-3528
Mailing Address - Country:US
Mailing Address - Phone:479-274-2000
Mailing Address - Fax:479-274-2194
Practice Address - Street 1:7001 ROGERS AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4073
Practice Address - Country:US
Practice Address - Phone:479-274-5000
Practice Address - Fax:479-274-5099
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1082207V00000X
OK17284207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR130307001Medicaid
160030838OtherRR MEDICARE
OK100737030AMedicaid
AR130307001Medicaid
ARF71190Medicare UPIN