| J P Mccubbin Md Pllc | |
|
4519 Wolfcreek Pkwy Louisville KY 40241-5501 | |
| (502) 742-9164 | |
| (502) 742-9395 |
| Full Name | J P Mccubbin Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4519 Wolfcreek Pkwy, Louisville, Kentucky |
| Authorized Official Name and Position | Jason P Mccubbin (PRESIDENT) |
| Authorized Official Contact | 5027429164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J P Mccubbin Md Pllc 4519 Wolfcreek Pkwy Louisville KY 40241-5501 Ph: (502) 742-9164 | J P Mccubbin Md Pllc 4519 Wolfcreek Pkwy Louisville KY 40241-5501 Ph: (502) 742-9164 |
| NPI Number | 1770719577 |
|---|---|
| Provider Enumeration Date | 06/08/2009 |
| Last Update Date | 06/03/2014 |
| Medicare PECOS PAC ID | 6709930126 |
|---|---|
| Medicare Enrollment ID | O20090820000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770719577 | NPI | - | NPPES |
| 7100072840 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jason P Mccubbin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437113396 PECOS PAC ID: 2668492448 Enrollment ID: I20080228000218 |
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