Individual
DR. OLDRICH V BUBENIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
604 N WASINGTON STREET, COUNCIL GROVE, KS 66846
(620) 767-5126
Mailing address
408 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703-5725
(573) 332-0808
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R2A65
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202167839
—
MO
Enumeration date
08/16/2006
Last updated
01/25/2016
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