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Organization

TONYA CANNON STEWART, OD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TONYA CANNON STEWART OD (OWNER)
(601) 925-2020
Entity
Organization

Contact information

Practice address
45 WEST LAKEVIEW DRIVE, CLINTON, MS 39056-5221
(601) 925-2020
(601) 925-2010
Mailing address
45 WEST LAKEVIEW DRIVE, CLINTON, MS 39056-5221
(601) 925-2020
(601) 925-2010

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
640
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880126
MS
01
410000282
MEDICARE ID-
MS
Enumeration date
03/02/2009
Last updated
05/06/2015
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