Provider Demographics
NPI:1144282948
Name:STUBBS, ALLSTON JULIUS (MD)
Entity type:Individual
Prefix:DR
First Name:ALLSTON
Middle Name:JULIUS
Last Name:STUBBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:140 KIMEL PARK DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6160
Mailing Address - Country:US
Mailing Address - Phone:336-245-2100
Mailing Address - Fax:336-768-7782
Practice Address - Street 1:140 KIMEL PARK DR
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6946
Practice Address - Country:US
Practice Address - Phone:336-245-2100
Practice Address - Fax:336-768-7782
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15589208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC210762DOtherMEDICARE
NC130023768OtherRR MEDICARE
NC2344759OtherMEDICARE GROUP
NC8980696Medicaid
NC130023768OtherRR MEDICARE
NC210762DOtherMEDICARE