Provider Demographics
NPI:1477879062
Name:LUEBBERS, JAMES ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ARNOLD
Last Name:LUEBBERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:687 EAST KELLY AVE.
Mailing Address - Street 2:BX 3797
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83001-3797
Mailing Address - Country:US
Mailing Address - Phone:307-734-6553
Mailing Address - Fax:307-733-8444
Practice Address - Street 1:687 EAST KELLY AVE.
Practice Address - Street 2:BX 3797
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-3797
Practice Address - Country:US
Practice Address - Phone:307-734-6553
Practice Address - Fax:307-733-8444
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG34211207W00000X
WY6046A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G342110Medicaid
CA00G342110Medicaid
CA00G342110Medicare PIN