Provider Demographics
NPI:1689470098
Name:STEWART, GREGORY DON JR (APSS)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:DON
Last Name:STEWART
Suffix:JR
Gender:
Credentials:APSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10443 W MANSLICK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRDALE
Mailing Address - State:KY
Mailing Address - Zip Code:40118-9563
Mailing Address - Country:US
Mailing Address - Phone:502-804-6835
Mailing Address - Fax:
Practice Address - Street 1:10443 W MANSLICK RD
Practice Address - Street 2:
Practice Address - City:FAIRDALE
Practice Address - State:KY
Practice Address - Zip Code:40118-9563
Practice Address - Country:US
Practice Address - Phone:502-804-6835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist