Individual
STEWART JOHN KANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
920 N QUINCY AVE, OTTUMWA, IA 52501-3866
(641) 455-5200
(641) 455-5150
Mailing address
920 N QUINCY AVE, OTTUMWA, IA 52501-3866
(641) 455-5200
(641) 455-5150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01944
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110134681
RAILROAD MEDICARE
IA
05
—
2193789
—
IA
05
—
3193789
—
IA
Enumeration date
02/17/2006
Last updated
10/20/2014
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