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Individual

DR. JOHN CALVIN STUBBLEFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
730 E BAYOU PINES DR, SUITE B, LAKE CHARLES, LA 70601-7184
(337) 491-9215
(337) 491-9218
Mailing address
730 E BAYOU PINES DR, SUITE B, LAKE CHARLES, LA 70601-7184
(337) 491-9215
(337) 491-9215

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
009849
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1110329
LA
Enumeration date
12/01/2005
Last updated
07/14/2010
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