Provider Demographics
NPI:1790244754
Name:LUBIN, JONATHAN ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ALEXANDER
Last Name:LUBIN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3400 E RACINE ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-2344
Mailing Address - Country:US
Mailing Address - Phone:608-373-8600
Mailing Address - Fax:608-373-8622
Practice Address - Street 1:3400 E RACINE ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-2344
Practice Address - Country:US
Practice Address - Phone:608-373-8600
Practice Address - Fax:608-373-8622
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI83752-202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology