Provider Demographics
NPI:1639481831
Name:CLUBB, ADRIAN B (MD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:B
Last Name:CLUBB
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:N-203
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0247
Mailing Address - Country:US
Mailing Address - Phone:352-273-8634
Mailing Address - Fax:352-273-7515
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:N-203
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0247
Practice Address - Country:US
Practice Address - Phone:352-273-8634
Practice Address - Fax:352-273-7515
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
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Provider Licenses
StateLicense IDTaxonomies
FLTRN15387208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology