Provider Demographics
NPI:1114121613
Name:CHUBB, PAUL JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:CHUBB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12793
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-0793
Mailing Address - Country:US
Mailing Address - Phone:915-581-0712
Mailing Address - Fax:915-833-7312
Practice Address - Street 1:1400 GEORGE DIETER DR
Practice Address - Street 2:STE100
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7653
Practice Address - Country:US
Practice Address - Phone:915-581-0712
Practice Address - Fax:915-833-7312
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7667207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102624203Medicaid
PA1601080OtherGATEWAY
MD045533400Medicaid
PAP01105025OtherRAILROAD MEDICARE
PA2650846OtherHIGHMARK BLUE SHIELD
PA417220OtherUPMC
PA1601080OtherGATEWAY
PA417220OtherUPMC