Individual
NED B HUBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
109 N TREMONT ST, KEWANEE, IL 61443-0146
(309) 852-2236
Mailing address
109 N TREMONT ST, KEWANEE, IL 61443-0146
(309) 852-2236
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007695
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007695
—
IL
01
—
363804415
TRICARE
—
01
—
P00129861
RR MEDICARE
—
Enumeration date
07/21/2005
Last updated
12/20/2013
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