MEDICARE: TITUS A. TAUBE M.D.

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	025296	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891752804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TITUS A. TAUBE M.D.

Provider Business Mailing Address
First Line	:	200 S HOUSTON LAKE RD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-9006
Country	:	US
Telephone Number	:	478-953-1800
Fax Number	:	478-953-1931

Provider Business Practice Location Address
First Line	:	200 S HOUSTON RD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-3906
Country	:	US
Telephone Number	:	478-953-1800
Fax Number	:	478-953-1931

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	02/15/2012

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