Individual
DR. JERRY LEROY HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
875 OAK ST SE, STE 5060, SALEM, OR 97301-3987
(503) 399-1386
(503) 399-1182
Mailing address
875 OAK ST SE, STE 5060, SALEM, OR 97301-3987
(503) 399-1386
(503) 399-1182
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD11848
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118968
—
OR
Enumeration date
06/21/2005
Last updated
04/10/2008
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