Hubbard, Jack Edward
Hubbard, Jack Edward is an individual health care provider with primary practice located at 675 E Nicollet Blvd Suite 100, Burnsville MN 55337-6749. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Hubbard, Jack Edward can be contacted via phone (952) 435-8516.Contact Information
Primary practice address
675 E Nicollet Blvd Suite 100
Burnsville MN 55337-6749
Phone: (952) 435-8516
Fax: (763) 302-4336
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 24157 | Minnesota |
Profile Details
| NPI number | 1194772103 |
|---|---|
| LBN Legal business name | Hubbard, Jack Edward |
| Credentials | PH.D., M.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Dec 1st, 2011 - about 15 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 | 1194772103 | NPPES |
| Minnesota | Other | 0265006 | PREFERRED ONE |
| Minnesota | Other | 0506197 | PREFERRED ONE |
| Minnesota | Other | HP13563 | PREFERRED ONE |
| Minnesota | MEDICAID | 829007500 | PREFERRED ONE |
| Minnesota | Other | 22668 | PREFERRED ONE |
| Minnesota | MEDICAID | 30478600 | PREFERRED ONE |
| Minnesota | Other | 07483HU | PREFERRED ONE |
| Minnesota | Other | 100285C029 | PREFERRED ONE |
| Minnesota | Other | 130004281 | PREFERRED ONE |
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