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General NPI Number Information
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NPI Number | 1760434161
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Entity Type | Individual
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Provider Name | JOHN P LUBICKY MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1 STADIUM DR
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City | MORGANTOWN
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State | WV
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Zip | 26506
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Country | US
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Telephone | 304-293-1312
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Fax | 304-293-7042
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER DRIVE PO BOX 9196
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City | MORGANTOWN
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State | WV
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Zip | 26506-9196
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Country | US
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Telephone | 304-293-1312
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Fax | 304-293-7042
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01061459A
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License Number State | IN
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