Provider Demographics
NPI:1508052168
Name:STEWART, EARL RAY JR (MD)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:RAY
Last Name:STEWART
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:14024 PRINCE WILLIAM WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35475-3670
Mailing Address - Country:US
Mailing Address - Phone:205-364-7135
Mailing Address - Fax:205-364-8244
Practice Address - Street 1:27340 HIGHWAY 86
Practice Address - Street 2:
Practice Address - City:GORDO
Practice Address - State:AL
Practice Address - Zip Code:35466-3578
Practice Address - Country:US
Practice Address - Phone:205-364-7135
Practice Address - Fax:205-364-8244
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2013-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL29112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine