MEDICARE: CHIVON STUBBS MD

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	207Q00000X	Family Medicine Physician	87681	GA

General Provider Information

NPI Number	:	1700380003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIVON STUBBS MD

Provider Business Mailing Address
First Line	:	PO BOX 738
Second Line	:
City	:	CLARKDALE
State	:	GA
Zip	:	30111-0738
Country	:	US
Telephone Number	:	470-322-5489
Fax Number	:

Provider Business Practice Location Address
First Line	:	3193 HOWELL MILL RD NW STE 125
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-2100
Country	:	US
Telephone Number	:	404-352-1223
Fax Number	:	404-352-1226

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

Provider Enumeration Date	:	03/21/2018
Last Update Date	:	02/11/2026

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Directions to “ CHIVON STUBBS MD” Practice Location

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