| Garry Stewart Md Pa | |
|
1545 Hogan Lane Conway AR 72034-1349 | |
| (501) 513-1225 | |
| (501) 513-1228 |
| Full Name | Garry Stewart Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1545 Hogan Lane, Conway, Arkansas |
| Authorized Official Name and Position | Garry Stewart (PRESIDENT) |
| Authorized Official Contact | 5015131225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garry Stewart Md Pa P.o. Box 11349 Conway AR 72034-1349 Ph: (501) 513-1225 | Garry Stewart Md Pa 1545 Hogan Lane Conway AR 72034-1349 Ph: (501) 513-1225 |
| NPI Number | 1457525933 |
|---|---|
| Provider Enumeration Date | 04/16/2008 |
| Last Update Date | 02/04/2010 |
| Medicare PECOS PAC ID | 7810031341 |
|---|---|
| Medicare Enrollment ID | O20100222000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457525933 | NPI | - | NPPES |
| 154599001 | Medicaid | AR | |
| 154599002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E3431 (Arkansas) | Primary |
| Provider Name | Garry L Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841293537 PECOS PAC ID: 7719977305 Enrollment ID: I20040515000083 |
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