MEDICARE: DR. JOSEPH TRUMAN STUBBS III MD

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
1	174400000X	Specialist	041008	GA
2	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	041008	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578592135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH TRUMAN STUBBS III MD

Provider Business Mailing Address
First Line	:	PO BOX 23028
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31403-3028
Country	:	US
Telephone Number	:	912-303-0891
Fax Number	:	912-303-0893

Provider Business Practice Location Address
First Line	:	5356 REYNOLDS ST
Second Line	:	STE 301
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6016
Country	:	US
Telephone Number	:	912-303-0891
Fax Number	:	912-303-0893

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	12/03/2013

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