Individual
MS. MALLORY E HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, DIV SURG TRANSPLANT, SAINT LOUIS, MO 63110-1003
(314) 747-9889
(314) 361-4197
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 747-9889
(314) 361-4197
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2020034088
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220090497
—
MO
Enumeration date
07/11/2019
Last updated
04/17/2025
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