Provider Demographics
NPI:1588614945
Name:ONG, STEWART (PT)
Entity Type:Individual
Prefix:MR
First Name:STEWART
Middle Name:
Last Name:ONG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 FOREST HILLS BLVD
Mailing Address - Street 2:STE. 205
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-3016
Mailing Address - Country:US
Mailing Address - Phone:479-855-9348
Mailing Address - Fax:479-855-9358
Practice Address - Street 1:1801 FOREST HILLS BLVD
Practice Address - Street 2:STE 205
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72715-3016
Practice Address - Country:US
Practice Address - Phone:479-855-9348
Practice Address - Fax:479-855-9358
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W438OtherBCBS
AR143683721Medicaid
AR5W438Medicare ID - Type Unspecified