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NPI Code Detail

MEDICARE: MR. KEVIN L KUBLY PA-C

MEDICARE: MR. KEVIN L KUBLY PA-C
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
1363A00000XPhysician Assistant8833-23WI
22083B0002XObesity Medicine (Preventive Medicine) PhysicianPADA978AK

General Provider Information

NPI Number : 1477523884
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN L KUBLY PA-C
Provider Business Mailing Address
First Line : 3300 FAIRBANKS ST STE A
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-4165
Country : US
Telephone Number : 907-561-3488
Fax Number :
Provider Business Practice Location Address
First Line : 1821 S STOUGHTON RD
Second Line :
City : MADISON
State : WI
Zip : 53716-2257
Country : US
Telephone Number : 608-260-6000
Fax Number : 608-252-8283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 04/08/2026

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