Provider Demographics
NPI:1639393200
Name:JOSEPH D. STEWART CHIROPRACTOR, INC.
Entity Type:Organization
Organization Name:JOSEPH D. STEWART CHIROPRACTOR, INC.
Other - Org Name:STEWART CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-531-3400
Mailing Address - Street 1:5514 CAMINO AL NORTE
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0807
Mailing Address - Country:US
Mailing Address - Phone:702-531-3400
Mailing Address - Fax:702-531-3404
Practice Address - Street 1:5514 CAMINO AL NORTE
Practice Address - Street 2:SUITE A-2
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-0807
Practice Address - Country:US
Practice Address - Phone:702-531-3400
Practice Address - Fax:702-531-3404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV100552Medicare ID - Type UnspecifiedINDIVIDUAL
NVU87291Medicare UPIN
NVV100551Medicare ID - Type UnspecifiedGROUP