Provider Demographics
NPI:1134681190
Name:STEWARDSON, KENDALL (DO)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:STEWARDSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:802 KENYON RD
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5740
Mailing Address - Country:US
Mailing Address - Phone:515-573-3101
Mailing Address - Fax:
Practice Address - Street 1:802 KENYON RD
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5740
Practice Address - Country:US
Practice Address - Phone:515-573-3101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-06008207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine