MEDICARE: DR. ALEX HLUBOCKY M.D.

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	2084N0400X	Neurology Physician	43082	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	43082	OTHER	AZ	AZ MEDICAL BOARD

General Provider Information

NPI Number	:	1679771950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX HLUBOCKY M.D.

Provider Business Mailing Address
First Line	:	2423 W DUNLAP AVE
Second Line	:	#130
City	:	PHOENIX
State	:	AZ
Zip	:	85021-5818
Country	:	US
Telephone Number	:	602-424-4450
Fax Number	:	602-424-4451

Provider Business Practice Location Address
First Line	:	2423 W DUNLAP AVE STE 175
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-5823
Country	:	US
Telephone Number	:	602-424-4450
Fax Number	:	602-424-4451

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

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	06/29/2021

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