Provider Demographics
NPI:1013302561
Name:STAUBS, ALEJANDRA (DO)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:STAUBS
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:SOTO-STAUBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1107 MEMORIAL DR STE G2
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8662
Mailing Address - Country:US
Mailing Address - Phone:706-529-3245
Mailing Address - Fax:706-272-6077
Practice Address - Street 1:1107 MEMORIAL DR STE G2
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8662
Practice Address - Country:US
Practice Address - Phone:706-529-3245
Practice Address - Fax:706-272-6077
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA080399207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine