Individual
KEVIN P SCHUBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
901 N PORTER AVE, NORMAN, OK 73071-6404
(317) 590-8663
Mailing address
5360 CHICO GREY DR, INDIANAPOLIS, IN 46237-3063
(317) 590-8663
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10003649A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/11/2020
Last updated
10/17/2024
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