Organization
HUBBARD BONE & JOINT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAWN GASTINEAU (OFFICE COORDINATOR)
(417) 255-2063
Entity
Organization
Contact information
Practice address
805 N KENTUCKY ST, WEST PLAINS, MO 65775-2022
(417) 255-2063
(417) 255-2062
Mailing address
805 N KENTUCKY ST, WEST PLAINS, MO 65775-2022
(417) 255-2063
(417) 255-2062
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
119275
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000014046
MEDICARE RR
—
05
—
244647806
—
MO
Enumeration date
09/27/2006
Last updated
08/03/2011
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