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General NPI Number Information
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NPI Number | 1336122480
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Entity Type | Individual
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Provider Name | GEOFFREY W GUBB MD
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 15249 ARTHUR'S COURT
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City | BELLE HAVEN
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State | VA
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Zip | 23306
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Country | US
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Telephone | 757-414-0595
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Fax | 757-414-0596
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Provider Business Mailing Address
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Address Line | PO BOX 274 15249 ARTHUR'S COURT
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City | BELLE HAVEN
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State | VA
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Zip | 23306-0274
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Country | US
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Telephone | 757-414-0595
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Fax | 757-414-0596
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101028868
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License Number State | VA
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