Provider Demographics
NPI:1689803918
Name:STEWART, PATRICIA HONEA (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:HONEA
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:LEIGH
Other - Last Name:HONEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7731 OLD CANTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6115
Mailing Address - Country:US
Mailing Address - Phone:601-499-0935
Mailing Address - Fax:601-499-0936
Practice Address - Street 1:7730 OLD CANTON RD BLDG B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9299
Practice Address - Country:US
Practice Address - Phone:601-499-0935
Practice Address - Fax:601-499-0936
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS22021207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01880336Medicaid
MS362811YS8TMedicare PIN