Provider Demographics
NPI:1801329958
Name:HUBBELL, ALICIA CLAIRE (MD, MBA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:CLAIRE
Last Name:HUBBELL
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 HEALTH CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6381
Mailing Address - Country:US
Mailing Address - Phone:405-717-6800
Mailing Address - Fax:
Practice Address - Street 1:INTEGRIS CANADIAN VALLEY HOSPITAL
Practice Address - Street 2:1201 HEALTH CENTER PARKWAY
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6381
Practice Address - Country:US
Practice Address - Phone:817-996-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK35491207R00000X, 207P00000X
TXS8575207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine