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General NPI Number Information
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NPI Number | 1295266161
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Entity Type | Individual
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Provider Name | JEAN CLAUDE JUBERT DO
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Gender | Male
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Dates
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Enumeration Date | 03/23/2017
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 314 W QUEEN ST
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City | EDENTON
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State | NC
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Zip | 27932-1733
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Country | US
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Telephone | 252-518-2561
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Fax |
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Provider Business Mailing Address
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Address Line | 109 W 27TH ST STE 5S
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City | NEW YORK
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State | NY
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Zip | 10001-6208
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Country | US
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Telephone | 833-351-8255
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 319868
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0102208075
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2022-02042
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License Number State | NC
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