Individual
DR. JACK EDWARD HUBBARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
24157
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0265006
PREFERRED ONE
MN
01
—
0506197
MEDICA
MN
01
—
07483HU
BCBS OF MN
MN
01
—
100285C029
UCARE
MN
01
—
130004281
RAILROAD MEDICARE
MN
01
—
22668
AMERICA'S PPO
MN
05
—
30478600
—
WI
05
—
829007500
—
MN
01
—
HP13563
HEALTHPARTNERS
MN
Enumeration date
05/27/2006
Last updated
12/01/2011
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