1699980466 NPI number — DRS. STEWART, BARR & THORNE,PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699980466 NPI number — DRS. STEWART, BARR & THORNE,PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. STEWART, BARR & THORNE,PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
STEWART, BARR & THORNE, DDS, INC.
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699980466
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 63 BOX 3560
Provider Second Line Business Mailing Address:
SUNRISE PROFESSIONAL BLDG
Provider Business Mailing Address City Name:
ROMNEY
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26757-9722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-822-4447
Provider Business Mailing Address Fax Number:
304-822-7943

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1035 FLORIDA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEYSER
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26726-2804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-788-6647
Provider Business Practice Location Address Fax Number:
301-777-3624
Provider Enumeration Date:
05/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STEWART
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
304-822-4447

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2289 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0136032000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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