Provider Demographics
NPI:1255377172
Name:HUBBELL, PATRICIA ANN (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:HUBBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN ALLPHIN
Other - Last Name:HUBBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:500 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1421
Mailing Address - Country:US
Mailing Address - Phone:740-363-1904
Mailing Address - Fax:740-363-5288
Practice Address - Street 1:500 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1421
Practice Address - Country:US
Practice Address - Phone:740-363-1904
Practice Address - Fax:740-363-5288
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.043057207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0449161Medicaid
OH000000019612OtherANTHEM BC/BS
OH000000019612OtherANTHEM BC/BS
A79810Medicare UPIN