Individual
JAMES G HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E 20TH ST, SUITE 110, CHEYENNE, WY 82001-3859
(307) 634-7711
Mailing address
2003 BLUEGRASS CIR, CHEYENNE, WY 82009-7329
(307) 634-7711
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
21266
NE
2085R0202X
Diagnostic Radiology Physician
29468
CO
2085R0202X
Diagnostic Radiology Physician
Primary
4525A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104805800
—
WY
01
—
306014
BCBS WYOMING
WY
05
—
91045252
—
CO
Enumeration date
06/16/2006
Last updated
03/18/2015
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