Provider Demographics
NPI:1730181819
Name:STABLER CLINIC, P.C.
Entity type:Organization
Organization Name:STABLER CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:NORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-382-2681
Mailing Address - Street 1:300 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-2025
Mailing Address - Country:US
Mailing Address - Phone:334-382-2681
Mailing Address - Fax:334-383-9541
Practice Address - Street 1:300 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-2025
Practice Address - Country:US
Practice Address - Phone:334-382-2681
Practice Address - Fax:334-383-9541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6791207Y00000X
ALDO343207Q00000X
AL14435208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALB60577Medicare UPIN
AL=========Medicare ID - Type UnspecifiedSTABLER CLINIC, P.C.
AL06046Medicare ID - Type UnspecifiedDR. AUBREY A. STABLER, JR
AL080553Medicare ID - Type UnspecifiedDR. DUANE J. WILLIAMS
ALC71292Medicare UPIN
ALE39262Medicare UPIN