Provider Demographics
NPI:1184621583
Name:STEWART, JOHN D II (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:STEWART
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4200 LAWRENCEBURG RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-8936
Mailing Address - Country:US
Mailing Address - Phone:502-227-4821
Mailing Address - Fax:502-227-3013
Practice Address - Street 1:4200 LAWRENCEBURG RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601
Practice Address - Country:US
Practice Address - Phone:502-227-4821
Practice Address - Fax:502-227-3013
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY23137207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64231376Medicaid
KY020039396Medicare PIN
KY64231376Medicaid
KY0542703Medicare PIN