Provider Demographics
NPI:1558839647
Name:HULBERT, ALVIN JEROME JR
Entity Type:Individual
Prefix:MR
First Name:ALVIN
Middle Name:JEROME
Last Name:HULBERT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4374 EVANGELINE ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-3536
Mailing Address - Country:US
Mailing Address - Phone:225-715-6978
Mailing Address - Fax:
Practice Address - Street 1:4374 EVANGELINE ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-3536
Practice Address - Country:US
Practice Address - Phone:225-715-6978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator