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Individual

BARRY A STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
923 E CENTRAL AVE, LA FOLLETTE, TN 37766-2768
(423) 907-1404
Mailing address
PO BOX 636019, CINCINNATI, OH 45263-6019
(800) 577-7707

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
18993
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3049590
BCBST
TN
05
3097502
TN
05
64921356
KY
01
P00232706
RAILROAD
TN
Enumeration date
09/21/2006
Last updated
02/08/2008
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