Basic Information
| Provider Information | |||||||||
| NPI: | 1760534846 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CINDY J STEWART PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | FAMILY FIRST VISION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2184 HENDERSON MILL RD NE | ||||||||
| Address2: | SUITE 12B | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303453762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709382923 | ||||||||
| FaxNumber: | 7709382943 | ||||||||
| Practice Location | |||||||||
| Address1: | 2184 HENDERSON MILL RD NE | ||||||||
| Address2: | SUITE 12B | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303453762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709382923 | ||||||||
| FaxNumber: | 7709382943 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 11/17/2017 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | STEWART | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
| AuthorizedOfficialMiddleName: | JEANNE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7709382923 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | OD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 870T | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.