Provider Demographics
NPI:1124196928
Name:ABENDAN DUBBERLY, JOSEFINA CATHRYN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEFINA
Middle Name:CATHRYN
Last Name:ABENDAN DUBBERLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2070
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31515-2070
Mailing Address - Country:US
Mailing Address - Phone:912-367-9841
Mailing Address - Fax:
Practice Address - Street 1:105 E TOLLISON ST STE D
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-0150
Practice Address - Country:US
Practice Address - Phone:912-366-9688
Practice Address - Fax:912-366-9888
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057562208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics