Provider Demographics
NPI:1730276353
Name:STEWART, HAROLD CHESTER JR (DC)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:CHESTER
Last Name:STEWART
Suffix:JR
Gender:M
Credentials:DC
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 7603
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-7603
Mailing Address - Country:US
Mailing Address - Phone:706-568-9091
Mailing Address - Fax:706-568-9054
Practice Address - Street 1:3507 GENTIAN BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907
Practice Address - Country:US
Practice Address - Phone:706-568-9091
Practice Address - Fax:706-568-9054
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
35ZCGHRMedicare ID - Type Unspecified
GAU85848Medicare UPIN