Provider Demographics
NPI:1952498172
Name:STEWART ONG, P.A.
Entity Type:Organization
Organization Name:STEWART ONG, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:T
Authorized Official - Last Name:ONG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:479-236-4987
Mailing Address - Street 1:11 MOUNTAIN BROOK CT
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3828
Mailing Address - Country:US
Mailing Address - Phone:479-236-4987
Mailing Address - Fax:
Practice Address - Street 1:11 MOUNTAIN BROOK CT
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3828
Practice Address - Country:US
Practice Address - Phone:479-236-4987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-08
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 2113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F464Medicare UPIN
AR5W438Medicare UPIN