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General NPI Number Information
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NPI Number | 1104812270
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Entity Type | Individual
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Provider Name | JOHN D TUBBS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 110 W. 2ND ST.
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City | STUART
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State | NE
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Zip | 68780-0070
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Country | US
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Telephone | 402-924-3777
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Fax | 402-924-3776
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Provider Business Mailing Address
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Address Line | PO BOX 377
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City | STUART
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State | NE
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Zip | 68780-0377
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Country | US
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Telephone | 402-924-3777
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Fax | 402-924-3776
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 22198
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 22198
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License Number State | NE
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