Individual
DR. LARRY DON STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1767 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
(337) 478-3810
(337) 478-6360
Mailing address
1767 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
(337) 478-3810
(337) 478-6360
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
10908
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1112755
—
LA
01
—
180011359
RAILROAD MEDICARE
LA
01
—
5658171
AETNA
LA
01
—
720680677014
CIGNA
LA
Enumeration date
11/16/2005
Last updated
05/26/2020
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