Organization Name: | UBBEN DERMATOLOGY CLINIC |
NPI Number: | 1194776906 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH L UBBEN (OWNER) |
Mailing Address: | 5 Cunningham Cor Bella Vista |
State: | AR US |
Postal Code: | 727143520 |
Phone Number: | 4798551247 |
Fax Number: | 4798551249 |
NPI Enumeration Date: | 05/15/2006 |
NPI Last Update Date: | 05/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | C-8212 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |