Provider Demographics
NPI:1720030091
Name:HUBBELL, CHRISTOPHER RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RAYMOND
Last Name:HUBBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:309 SETTLERS TRACE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508
Mailing Address - Country:US
Mailing Address - Phone:337-981-6065
Mailing Address - Fax:337-981-6066
Practice Address - Street 1:309 SETTLERS TRACE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-981-6065
Practice Address - Fax:337-981-6066
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019067207ND0101X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA136891Medicaid
LA136891Medicaid
LA53403Medicare ID - Type Unspecified