Individual
JASON TRYGVE STUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3654 N INVESTMENT DR # 120, FAYETTEVILLE, AR 72703-5441
(216) 904-6596
Mailing address
3654 N INVESTMENT DR # 120, FAYETTEVILLE, AR 72703-5441
(216) 904-6596
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
02004173A
IN
207YS0123X
Facial Plastic Surgery Physician
Primary
5101022863
MI
208200000X
Plastic Surgery Physician
5101022863
MI
Other
Enumeration date
06/19/2007
Last updated
05/30/2024
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