Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K8218 | TX |
Y | 208600000X | Surgeon | K8218 | TX |
NPI | 1013981992 |
---|---|
Provider Name | Dr. Bruce C Hubert |
First Address | Gilbert, AZ 85298-4614 |
Second Address | Gilbert, AZ 85298-4614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 15/06/2011 |