Provider Demographics
NPI:1356359186
Name:HUEBNER, MELBURN KENTON (MD)
Entity type:Individual
Prefix:DR
First Name:MELBURN
Middle Name:KENTON
Last Name:HUEBNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MEDI PARK
Mailing Address - Street 2:STE 10
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79016-2105
Mailing Address - Country:US
Mailing Address - Phone:806-356-2525
Mailing Address - Fax:806-356-2527
Practice Address - Street 1:1901 MEDI PARK
Practice Address - Street 2:STE 10
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79016-2105
Practice Address - Country:US
Practice Address - Phone:806-356-2525
Practice Address - Fax:806-356-2527
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0473207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115582100OtherFIRST CARE
200007021OtherRAILROAD MEDICARE
TX089780302Medicaid
TX00F70TMedicare ID - Type Unspecified
200007021OtherRAILROAD MEDICARE
E55990Medicare UPIN