Individual
DONALD KENNETH STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 MEDICAL CENTER DR, PADUCAH, KY 42003
(270) 442-1024
(270) 442-1001
Mailing address
245 HIGH POINTE DR, PADUCAH, KY 42003-8819
(270) 554-5725
(270) 442-1001
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
105A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000035277
KY BCBS
KY
05
—
2605018000
—
WV
05
—
74240185
—
KY
01
—
P00158032
RR MEDICARE
KY
Enumeration date
09/19/2005
Last updated
04/04/2008
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