Provider Demographics
NPI:1922143957
Name:STEWART, JAMES K (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:K
Last Name:STEWART
Suffix:
Gender:M
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8926
Mailing Address - Country:US
Mailing Address - Phone:724-439-4380
Mailing Address - Fax:724-439-4348
Practice Address - Street 1:10 HIGHLAND PARK DR
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8926
Practice Address - Country:US
Practice Address - Phone:724-439-4380
Practice Address - Fax:724-439-4348
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000835L237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01667535Medicaid
PA01667535Medicaid
PAR06716Medicare UPIN