Organization
J P MCCUBBIN MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON P MCCUBBIN M.D. (PRESIDENT)
(502) 742-9164
Entity
Organization
Contact information
Practice address
4519 WOLFCREEK PKWY, LOUISVILLE, KY 40241-5501
(502) 742-9164
(502) 742-9395
Mailing address
4519 WOLFCREEK PKWY, LOUISVILLE, KY 40241-5501
(502) 742-9164
(502) 742-9395
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100072840
—
KY
Enumeration date
06/08/2009
Last updated
06/03/2014
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