MEDICARE: COREY MICHAEL STUBBS D.C.

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	111N00000X	Chiropractor	3657	OK

General Provider Information

NPI Number	:	1033220918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COREY MICHAEL STUBBS D.C.

Provider Business Mailing Address
First Line	:	9709 E 79TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-4566
Country	:	US
Telephone Number	:	918-994-4048
Fax Number	:	918-994-4090

Provider Business Practice Location Address
First Line	:	9709 E 79TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-4566
Country	:	US
Telephone Number	:	918-994-4000
Fax Number	:	918-994-4090

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/25/2022

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