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General NPI Number Information
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NPI Number | 1578585519
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Entity Type | Organization
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Legal Business Name | JUNEAU D STUMP JR MD PC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 18 E BEECH ST
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4134
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Country | US
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Telephone | 928-634-2233
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1904
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City | COTTONWOOD
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State | AZ
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Zip | 86326-1904
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Country | US
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Telephone | 928-634-0665
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUNEAU D STUMP JR.
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Credential | MD
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Telephone | 928-634-2233
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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 | 7971
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License Number State | AZ
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