Provider Demographics
NPI:1538353453
Name:DR RICHARD S STEWART & ASSOCIATES PC
Entity type:Organization
Organization Name:DR RICHARD S STEWART & ASSOCIATES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:623-566-3937
Mailing Address - Street 1:10006 W HAPPY VALLEY RD
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1235
Mailing Address - Country:US
Mailing Address - Phone:623-566-3937
Mailing Address - Fax:623-566-1840
Practice Address - Street 1:10006 W HAPPY VALLEY RD
Practice Address - Street 2:SUITE 1250
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-1235
Practice Address - Country:US
Practice Address - Phone:623-566-3937
Practice Address - Fax:623-566-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZOD855BMedicare PIN
AZU24861Medicare UPIN
AZDQ9084Medicare PIN