MEDICARE: ASA M HUBBARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	R2598	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8CU832	OTHER	TX	BCBS
4	8CV125	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1134160617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASA M HUBBARD MD

Provider Business Mailing Address
First Line	:	PO BOX 511
Second Line	:
City	:	MOUNT PLEASANT
State	:	TX
Zip	:	75456-0511
Country	:	US
Telephone Number	:	903-577-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 N JEFFERSON AVE
Second Line	:
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-2338
Country	:	US
Telephone Number	:	903-577-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	09/20/2018

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Directions to “ ASA M HUBBARD MD” Practice Location

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