Basic Information
| Provider Information | |||||||||
| NPI: | 1518956994 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STUART | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | SIDNEY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2114 AIRPORT BLVD | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325048926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504763696 | ||||||||
| FaxNumber: | 8504773573 | ||||||||
| Practice Location | |||||||||
| Address1: | 2114 AIRPORT BLVD | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325048926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504763696 | ||||||||
| FaxNumber: | 8504773573 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2005 | ||||||||
| LastUpdateDate: | 07/19/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | ME50908 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 046259400 | 05 | FL | MEDICAID | 9505 | 01 | FL | HEALTH FIRST NETWORK | OTHER | 59082867 | 01 | FL | BCBS AL | OTHER | 3394306 | 01 | FL | CIGNA | OTHER | 5243083 | 01 | FL | AETNA | OTHER | 0706921 | 01 | FL | UNITED HEALTHCARE | OTHER | P00105328 | 01 | FL | MEDICARE RR | OTHER | 04103 | 01 | FL | BCBSFL | OTHER |