DR. JACK EDWARD HUBBARD PH.D. M.D. NPI 1194772103

NPI Information

NPI: 1194772103
Provider Name: DR. JACK EDWARD HUBBARD, PH.D., M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

Address:
675 E NICOLLET BLVD
SUITE 100
BURNSVILLE, MN
ZIP 55337
Phone: (952) 435-8516
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DR. Jack Edward Hubbard, PH.D., M.D. is a neurology psychiatry neurology in Burnsville, MN. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Jack Edward Hubbard, PH.D., M.D. NPI is 1194772103. 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:

675 E NICOLLET BLVD
SUITE 100
BURNSVILLE, MN
ZIP 55337-749
Phone: (952) 435-8516
Fax: (763) 302-4336

The enumeration date for this NPI number is 5/27/2006 and was last updated on 12/1/2011.

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	2084N0400X	Psychiatry & Neurology	Neurology	24157	MINNESOTA	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	100285C029	OTHER	MINNESOTA	UCARE
2	07483HU	OTHER	MINNESOTA	BCBS OF MN
3	HP13563	OTHER	MINNESOTA	HEALTHPARTNERS
4	A94453	MEDICARE UPIN	MINNESOTA
5	130000063	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	MEDICARE
6	30478600	MEDICAID	WISCONSIN
7	829007500	MEDICAID	MINNESOTA
8	0506197	OTHER	MINNESOTA	MEDICA
9	0265006	OTHER	MINNESOTA	PREFERRED ONE
10	130004281	OTHER	MINNESOTA	RAILROAD MEDICARE
11	22668	OTHER	MINNESOTA	AMERICA'S PPO

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: 4/28/2024

NPI Synchronization or Removal

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