Bubolz, Justin F
Bubolz, Justin F is an individual health care provider with primary practice located at 100 Medical Dr , Hannibal MO 63401-6877. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bubolz, Justin F can be contacted via phone (573) 231-3102.Contact Information
Primary practice address
100 Medical Dr
Hannibal MO 63401-6877
Phone: (573) 231-3102
Fax: (573) 231-3723
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | R2H02 | Missouri |
Profile Details
| NPI number | 1962481630 |
|---|---|
| LBN Legal business name | Bubolz, Justin F |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2006 |
| Last updated | Oct 8th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962481630 | NPPES |
| Missouri | MEDICAID | 209722503 |
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