Individual
GEORGE KUBAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 DAGGETT AVE STE 101, KLAMATH FALLS, OR 97601-1126
(541) 884-6233
(541) 880-2840
Mailing address
PO BOX 2120, PORTLAND, OR 97208-2120
(541) 884-6233
(541) 880-2840
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
MD20381
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060051986
RAILROAD MEDICARE
—
01
—
060060517
RAILROAD MEDICARE
—
05
—
164981
—
OR
Enumeration date
12/20/2006
Last updated
11/04/2022
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