Doctor Name: | MR. JACOB EMIL GUBLER |
NPI Number: | 1124303888 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 5033 |
Business Practice Address: | 483 W Seed Farm Rd Sacaton, AZ - 851470038 |
Business Phone Number: | 6025281200 |
Business Fax Number: | 6025281255 |
Mailing Address: | Po Box 38, SACATON |
State: | AZ |
Postal Code: | 851470001 |
Phone Number: | 6025281200 |
Fax Number: | 6025281255 |
NPI Enumeration Date: | 10/13/2011 |
NPI Last Update Date: | 10/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 5033 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |