Individual
JASON P MCCUBBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E CHESTNUT ST BLDG SUITE303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(502) 629-3132
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41405
KY
208M00000X
Hospitalist Physician
41405
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000548629
ANTHEM- NORTON
KY
01
—
000000629999
ANTHEM
KY
01
—
01066001
MEDICARE
KY
05
—
300070817
—
IN
05
—
7100061930
—
KY
01
—
K422500
MEDICARE
KY
01
—
P00470242
RAILROAD MEDICARE- NORTON CMA
KY
Enumeration date
04/17/2006
Last updated
02/28/2023
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