Healthcare Provider Details

I. General information

NPI: 1104232255
Provider Name (Legal Business Name): JAMES HUBBARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10777 SUNSET OFFICE DR STE 120
SAINT LOUIS MO
63127-1019
US

IV. Provider business mailing address

10777 SUNSET OFFICE DR STE 120
SAINT LOUIS MO
63127-1019
US

V. Phone/Fax

Practice location:
  • Phone: 314-966-0111
  • Fax:
Mailing address:
  • Phone: 314-966-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2021031343
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: