MEDICARE: DR. SHAWN 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	AL1449	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	510-75104	OTHER	AL	BCBS OF AL

General Provider Information

NPI Number	:	1376505818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN STUBBS D.C.

Provider Business Mailing Address
First Line	:	2826 MOODY PKWY
Second Line	:	STE A
City	:	MOODY
State	:	AL
Zip	:	35004-3101
Country	:	US
Telephone Number	:	205-640-6500
Fax Number	:	205-640-7073

Provider Business Practice Location Address
First Line	:	2826 MOODY PKWY
Second Line	:	STE A
City	:	MOODY
State	:	AL
Zip	:	35004-3101
Country	:	US
Telephone Number	:	205-640-6500
Fax Number	:	205-640-7073

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	12/06/2018

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Directions to “ DR. SHAWN STUBBS D.C.” Practice Location

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