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General NPI Number Information
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NPI Number | 1578192878
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Entity Type | Individual
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Provider Name | MICAH ANDREW STAPLES DO
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Gender | Male
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 201 DOLIVE ST
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City | BAY MINETTE
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State | AL
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Zip | 36507-3226
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Country | US
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Telephone | 251-706-8700
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Fax | 251-937-6179
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Provider Business Mailing Address
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Address Line | 201 DOLIVE ST
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City | BAY MINETTE
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State | AL
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Zip | 36507-3226
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Country | US
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Telephone | 251-706-8700
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Fax | 251-937-6179
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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 | DO.2702
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License Number State | AL
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