Healthcare Provider Details

I. General information

NPI: 1104812270
Provider Name (Legal Business Name): JOHN D TUBBS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 07/30/2024
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W. 2ND ST.
STUART NE
68780-0070
US

IV. Provider business mailing address

PO BOX 377
STUART NE
68780-0377
US

V. Phone/Fax

Practice location:
  • Phone: 402-924-3777
  • Fax: 402-924-3776
Mailing address:
  • Phone: 402-924-3777
  • Fax: 402-924-3776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number22198
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22198
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: