Individual
MR. TYSON E BUBNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1325 LOCUST AVE, FAIRMONT, WV 26554-1435
(907) 947-4406
Mailing address
23434 GLENN HILL CIR, CHUGIAK, AK 99567-6278
(907) 947-4406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
699
WV
363A00000X
Physician Assistant
931
AK
Other
Enumeration date
09/22/2009
Last updated
05/27/2025
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