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Individual

DR. WARREN GRADY STUMBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
566 HIGHWAY 899, HINDMAN, KY 41822
(606) 785-3164
(606) 785-0107
Mailing address
566 HIGHWAY 899, BOX 849, HINDMAN, KY 41822-9998
(606) 785-3164
(606) 785-0107

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16312
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64162124
KY
05
64163124
KY
Enumeration date
02/21/2007
Last updated
03/02/2020
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