Individual
REBECCA CONDON STAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
39 KENT RD STE 5, TIFTON, GA 31794-1697
(229) 353-7337
Mailing address
907 E 18TH STREET, SUITE 150, TIFTON, GA 31794
(229) 353-3450
(229) 353-6060
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
075158
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2014
Last updated
10/20/2021
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