Individual
MR. JOSEPH H. KUBICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1650 COCHRANE CIR, FT CARSON, CO 80913-4603
(719) 526-7844
(719) 526-7132
Mailing address
705 MIDNIGHT LN, FLORISSANT, CO 80816-9269
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00582
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012292
NCCPA
—
Enumeration date
02/17/2006
Last updated
09/04/2007
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