Individual
DR. JOEL T HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
194 CLARKSON RD, ELLISVILLE, MO 63011-2244
(636) 227-2020
Mailing address
PO BOX 207158, DALLAS, TX 75320-7158
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2003014764
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11814229
CAQH
—
01
—
2003014764
MISSOURI LICENSE
—
Enumeration date
12/28/2006
Last updated
10/11/2022
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