Provider Demographics
NPI:1578729737
Name:DAVID HUBLER MD PLLC
Entity Type:Organization
Organization Name:DAVID HUBLER MD PLLC
Other - Org Name:ADA BONE & JOINT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-714-8514
Mailing Address - Street 1:PO BOX 382721
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75138-2721
Mailing Address - Country:US
Mailing Address - Phone:972-291-9415
Mailing Address - Fax:440-425-5239
Practice Address - Street 1:520 N MONTE VISTA ST STE C
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4674
Practice Address - Country:US
Practice Address - Phone:214-714-8514
Practice Address - Fax:440-425-5239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23657207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200019500AMedicaid
OKB23615Medicare UPIN
OK900522162Medicare PIN