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NPI Code Detail

MEDICARE: JONATHAN STABILE DO, MPH

MEDICARE:   JONATHAN  STABILE  DO, MPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083A0100XAerospace Medicine Physician9901328NC

General Provider Information

NPI Number : 1043294788
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN STABILE DO, MPH
Provider Business Mailing Address
First Line : 300 HOSPITAL ROAD
Second Line : HYPERBARIC MEDICINE DEPARTMENT
City : FORT GORDON
State : GA
Zip : 30905-5650
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 HOSPITAL ROAD
Second Line : HYPERBARIC MEDICINE DEPARTMENT
City : FORT GORDON
State : GA
Zip : 30905-5650
Country : US
Telephone Number : 706-787-3113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 08/18/2014

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