DR. JUSTIN F BUBOLZ M.D. NPI 1962481630

NPI Information

  • NPI: 1962481630
  • Provider Name: DR. JUSTIN F BUBOLZ, M.D.
  • Classification: Pediatrics - 208000000X
  • Entity Type: Individual
  • Address: 100 MEDICAL DR
    HANNIBAL, MO
    ZIP 63401
  • Phone: (573) 231-3102

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NPI Details

DR. Justin F Bubolz, M.D. is a pediatrics in Hannibal, MO. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Justin F Bubolz, M.D. NPI is 1962481630. 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:

100 MEDICAL DR
HANNIBAL, MO
ZIP 63401-877
Phone: (573) 231-3102
Fax: (573) 231-3723

The enumeration date for this NPI number is 1/11/2006 and was last updated on 10/8/2021.

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
1208000000XPediatricsR2H02MISSOURIYes

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
1209722503MEDICAIDMISSOURI

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: 3/30/2025

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