Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 041008 | GA |
NPI | 1578592135 |
---|---|
Provider Name | Dr. Joseph Truman Stubbs III |
First Address | Savannah, GA 31403-3028 |
Second Address | Savannah, GA 31405-6016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 03/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000758777B | (05) | GA |
G54572 | (02) | GA |