Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2700 | OK |
NPI | 1003844952 |
---|---|
Provider Name | Dr. Frank L Hubbard |
First Address | Cushing, OK 74023-1707 |
Second Address | Cushing, OK 74023-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B18403 | (02) | OK |