Organization
STUBBS PROSTHETICS & ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MARK STUBBS CPO (CEO)
(423) 698-1778
Entity
Organization
Contact information
Practice address
1213 BROADRICK DR, DALTON, GA 30720-2504
(706) 259-4563
(706) 259-4775
Mailing address
5715 UPTAIN RD STE 5800, CHATTANOOGA, TN 37411-5655
(423) 698-1778
(423) 698-1741
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3141176
BCBST
TN
05
—
3541423
—
TN
01
—
483452058B
MEDICAID
GA
Enumeration date
12/06/2005
Last updated
03/23/2022
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