Individual
JACK L STUBER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1112 W 6TH ST, SUITE 110, LAWRENCE, KS 66044-2215
(785) 841-3211
Mailing address
2500 W 64TH ST, MISSION HILLS, KS 66208-1912
(785) 841-3211
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0413803
KS
Other
Enumeration date
05/26/2006
Last updated
07/08/2007
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