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Individual

JOHN MIKEL HUBANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2902 W AGUA FRIA FWY STE 1000, PHOENIX, AZ 85027-3969
(623) 582-6420
Mailing address
10200 GRAND CENTRAL AVE STE 220, OWINGS MILLS, MD 21117-4366

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
47163
AZ
208800000X
Urology Physician
51942
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
780254
AZ
05
ENROLLED
IA
05
ENROLLED
MN
01
P00970223
RAILROAD MEDICARE
MN
Enumeration date
07/19/2008
Last updated
03/21/2025
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