DAVID JEROME LUBBERS MD NPI 1134111503

NPI Information

NPI: 1134111503
Provider Name: DAVID JEROME LUBBERS, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Address:
1 MEDICAL VILLAGE DR
EDGEWOOD, KY
ZIP 41017
Phone: (859) 301-2160
Get Directions

David Jerome Lubbers, MD is a diagnostic radiology radiology in Edgewood, KY. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. David Jerome Lubbers, MD NPI is 1134111503. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1 MEDICAL VILLAGE DR
EDGEWOOD, KY
ZIP 41017-403
Phone: (859) 301-2160
Fax: (859) 301-3932

The enumeration date for this NPI number is 8/22/2005 and was last updated on 8/7/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		24507	KENTUCKY	No
2	2085R0202X	Radiology	Diagnostic Radiology	24507	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3313158	MEDICARE PIN	KENTUCKY
2	300013439	OTHER		RRMC
3	3400160	MEDICARE PIN	KENTUCKY
4	1269616	MEDICARE PIN	KENTUCKY
5	300073609	MEDICARE PIN	KENTUCKY
6	0060564	MEDICAID	OHIO
7	0655090	MEDICARE PIN	KENTUCKY
8	0592569	MEDICAID	OHIO
9	C72735	MEDICARE UPIN
10	64245079	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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