Provider Demographics
NPI:1780785899
Name:STEWART, JAMES J JR (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:J
Last Name:STEWART
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-334-8700
Mailing Address - Fax:859-334-8707
Practice Address - Street 1:2000 LITTON LN
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-8611
Practice Address - Country:US
Practice Address - Phone:859-334-8700
Practice Address - Fax:859-334-8707
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-088201207Q00000X
IN01064022A207Q00000X
KY43027207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100091390Medicaid
IN200868850Medicaid
OH2675467Medicaid
OH2675467Medicaid
KY00858009Medicare PIN
KY7100091390Medicaid
IN200868850Medicaid