Individual
JAMES MCCUBBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 517-3123
Mailing address
1122 BROOK RUN RD, HALIFAX, VA 24558-3004
(434) 476-2421
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
0101243579
VA
207P00000X
Emergency Medicine Physician
0101243579
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720090376
NPI
VA
Enumeration date
08/12/2006
Last updated
01/21/2021
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