MEDICARE: DR. JASON C HUBBARD D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	L4978	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00108951	OTHER	TX	RR MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8M7060	OTHER	TX	BCBS IND #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699779348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON C HUBBARD D.O.

Provider Business Mailing Address
First Line	:	1749 PINE ST
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79601-3043
Country	:	US
Telephone Number	:	325-646-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	919 EARLY BLVD STE 1C
Second Line	:
City	:	EARLY
State	:	TX
Zip	:	76802-2208
Country	:	US
Telephone Number	:	325-646-9900
Fax Number	:	325-641-3109

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	04/03/2013

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