Healthcare Provider Details

I. General information

NPI: 1902868722
Provider Name (Legal Business Name): JAMES ELSTON HUBBARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81-915 MANAWA ST
KEALAKEKUA HI
96750-8108
US

IV. Provider business mailing address

PO BOX 210
KEALAKEKUA HI
96750-0210
US

V. Phone/Fax

Practice location:
  • Phone: 808-896-1124
  • Fax:
Mailing address:
  • Phone: 808-896-1124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD-8121
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: