Healthcare Provider Details

I. General information

NPI: 1881796571
Provider Name (Legal Business Name): JON SZUBSKI CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 E MOUNT VIEW DR
CORINTH MS
38834-9143
US

IV. Provider business mailing address

1905 E MOUNT VIEW DR
CORINTH MS
38834-9143
US

V. Phone/Fax

Practice location:
  • Phone: 330-853-0139
  • Fax:
Mailing address:
  • Phone: 330-853-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number25674
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number864936
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: