Provider Demographics
NPI:1801802723
Name:HUBBARD, WILLIAM ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANDREW
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:ANDREW
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:W ANDREW HUBBARD
Mailing Address - Street 1:6600 AVONDALE DR
Mailing Address - Street 2:
Mailing Address - City:NICHOLS HILLS
Mailing Address - State:OK
Mailing Address - Zip Code:73116-6018
Mailing Address - Country:US
Mailing Address - Phone:405-627-2762
Mailing Address - Fax:405-478-8663
Practice Address - Street 1:3366 NW EXPRESSWAY STE 750
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4454
Practice Address - Country:US
Practice Address - Phone:405-948-2020
Practice Address - Fax:405-948-2760
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9044207W00000X, 207WX0107X
OK9055207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100116730AMedicaid
OK800522012Medicare PIN
OKD91072Medicare UPIN