Individual
THOMAS HUBBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6901 N 72ND STREET, OMAHA, NE 68122-1799
(402) 572-2225
Mailing address
PO BOX 31058, OMAHA, NE 68131-0058
(886) 898-7142
(616) 975-9824
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1122
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00102788
RR MCR
—
Enumeration date
06/07/2006
Last updated
10/27/2007
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