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General NPI Number Information
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NPI Number | 1689811390
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Entity Type | Organization
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Legal Business Name | SEBASTIAN O. HUBBUCH M.D.
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/19/2009
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Provider Practice Location Address
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Address Line | 3808 GENTIAN BLVD
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City | COLUMBUS
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State | GA
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Zip | 31907-1147
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Country | US
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Telephone | 706-565-7382
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Fax | 706-565-9110
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Provider Business Mailing Address
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Address Line | PO BOX 8709
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City | COLUMBUS
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State | GA
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Zip | 31908-8709
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Country | US
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Telephone | 706-565-7382
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Fax | 706-565-9110
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SEBASTIAN OTTO HUBBUCH
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Credential | M.D.
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Telephone | 706-565-7382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 532
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 242
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 16161
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License Number State | AL
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