MEDICARE: JOHN R STRIPLING III MD LLC

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	208800000X	Urology Physician	0298000	GA

General Provider Information

NPI Number	:	1942474481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN R STRIPLING III MD LLC

Provider Business Mailing Address
First Line	:	10700 MEDLOCK BRIDGE RD
Second Line	:	SUITE 204
City	:	DULUTH
State	:	GA
Zip	:	30097-8456
Country	:	US
Telephone Number	:	678-356-2000
Fax Number	:	678-990-3395

Provider Business Practice Location Address
First Line	:	10700 MEDLOCK BRIDGE RD
Second Line	:	SUITE 204
City	:	DULUTH
State	:	GA
Zip	:	30097-8456
Country	:	US
Telephone Number	:	678-356-2000
Fax Number	:	678-990-3395

Authorized Official
Title or Position	:	OWNER/ PHYSICIAN
Name	:	JOHN R STRIPLING III
Credential	:	MD
Telephone Number	:	678-356-2000

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	05/02/2008

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