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Individual

MR. DOUG HUGH STEWART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.D.O.

Contact information

Practice address
1550 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4161
(904) 354-1021
(904) 355-7840
Mailing address
1550 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4161
(904) 354-1021
(904) 355-7840

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO3413
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06704100001
DME
FL
Enumeration date
01/10/2008
Last updated
09/09/2013
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