Provider Demographics
NPI:1306848486
Name:STUART, DENISE F (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:F
Last Name:STUART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 HARTSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2523
Mailing Address - Country:US
Mailing Address - Phone:615-451-9246
Mailing Address - Fax:615-575-5040
Practice Address - Street 1:262 NEW SHACKLE ISLAND RD
Practice Address - Street 2:SUITE 203
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2489
Practice Address - Country:US
Practice Address - Phone:615-824-1142
Practice Address - Fax:615-264-3635
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD41251208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3833519OtherMEDICARE
TN1503276Medicaid