Provider Demographics
NPI:1265499966
Name:HUBBARD, LEONARD FIELD (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:FIELD
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 RESERVOIR AVENUE
Mailing Address - Street 2:STE 301
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920
Mailing Address - Country:US
Mailing Address - Phone:401-942-0280
Mailing Address - Fax:401-946-7230
Practice Address - Street 1:1150 RESERVOIR AVENUE
Practice Address - Street 2:STE 301
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-942-0280
Practice Address - Fax:401-946-7230
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI5673207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI001072OtherBLUE CHIP OF RI
RI00000023643OtherBCBC OF RI
RI7002910Medicaid
007002910Medicare ID - Type Unspecified
RI7002910Medicaid