Provider Demographics
NPI:1568673861
Name:DANIEL K STUBLER MD PC
Entity Type:Organization
Organization Name:DANIEL K STUBLER MD PC
Other - Org Name:DANIEL K STUBLER MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:STUBLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-990-8797
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36533-0374
Mailing Address - Country:US
Mailing Address - Phone:251-990-8797
Mailing Address - Fax:251-990-8558
Practice Address - Street 1:919 PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-2949
Practice Address - Country:US
Practice Address - Phone:251-990-8797
Practice Address - Fax:251-990-8558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD16025174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE93700Medicare UPIN
ALL190Medicare ID - Type UnspecifiedGROUP NUMBER