Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

W.b. Stewart Tigers Athletics Boosters

Organization Pediatric Adolescent Medicine Physician · NPI 1841794682

W.b. Stewart Tigers Athletics Boosters is a Pediatric Adolescent Medicine Physician in Jacksonville, Florida. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

1658 Kings Rd
Jacksonville, FL 32209-6167
Phone: (972) 367-4845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X

Record details

NPI number1841794682
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Agent · (972) 367-4845
Other names Ewc Sports Medicine
NPI enumeratedMarch 19, 2018
Last updated in NPPESMarch 19, 2018
Mailing address5050 Spring Valley Rd, Dallas, TX 75244-3995

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