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NPI Code Detail

MEDICARE: SAMANTHA KUEBLER

MEDICARE: SAMANTHA KUEBLER
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
1363A00000XPhysician Assistant
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1538867510
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA KUEBLER
Provider Business Mailing Address
First Line : 3696 WHEELER RD
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6520
Country : US
Telephone Number : 706-736-1830
Fax Number : 706-650-7553
Provider Business Practice Location Address
First Line : 1220 GEORGE C WILSON DR
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-4501
Country : US
Telephone Number : 762-716-1012
Fax Number : 762-716-1013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2023
Last Update Date : 11/14/2024

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Directions to “ SAMANTHA KUEBLER ” Practice Location

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