Provider Demographics
NPI:1942538897
Name:DUNCAN L HUBBARD, MD, PC
Entity Type:Organization
Organization Name:DUNCAN L HUBBARD, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUNCAN
Authorized Official - Middle Name:LANG
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-721-5681
Mailing Address - Street 1:2831 FORT MISSOULA RD
Mailing Address - Street 2:304
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7419
Mailing Address - Country:US
Mailing Address - Phone:406-721-5681
Mailing Address - Fax:406-721-2661
Practice Address - Street 1:2831 FORT MISSOULA RD
Practice Address - Street 2:304
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7419
Practice Address - Country:US
Practice Address - Phone:406-721-5681
Practice Address - Fax:406-721-2661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4976261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT072553Medicaid
MT0354780001Medicare NSC
MT072553Medicaid
MTD07952Medicare UPIN