MEDICARE: DR. STUART TOBIN 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	207NS0135X	Procedural Dermatology Physician	18026	KY

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	:	1801893730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART TOBIN MD

Provider Business Mailing Address
First Line	:	800 ROSE ST., ROOM C225
Second Line	:	UNIVERSITY OF KENTUCKY, DEPT. OF SURGERY
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0293
Country	:	US
Telephone Number	:	859-323-6346
Fax Number	:	859-323-6840

Provider Business Practice Location Address
First Line	:	740 S. LIMESTONE, RM L119
Second Line	:	UNIVERSITY OF KENTUCKY, KY CLINIC
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0284
Country	:	US
Telephone Number	:	859-257-3253
Fax Number	:	859-323-6840

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	11/14/2012

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