Provider Demographics
NPI:1881610830
Name:HUBBARD, GEORGE R (PA)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:R
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W STATE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2250
Mailing Address - Country:US
Mailing Address - Phone:215-348-3068
Mailing Address - Fax:215-348-7428
Practice Address - Street 1:800 W STATE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2250
Practice Address - Country:US
Practice Address - Phone:215-348-3068
Practice Address - Fax:215-348-7428
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA003149L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P92637Medicare UPIN
PA071056H6YMedicare ID - Type Unspecified
PA071056Medicare PIN