| Doctor Name: | TIMOTHY HUBBARD |
| NPI Number: | 1669889390 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 2014023848 |
| Business Practice Address: | 1312 N. Highway 5 Ava, MO - 65608 |
| Business Phone Number: | 4176834045 |
| Business Fax Number: | 4176836069 |
| Mailing Address: | 275s School Ave, HARTVILLE |
| State: | MO |
| Postal Code: | 656678406 |
| Phone Number: | 4177417484 |
| Fax Number: | 9898927455 |
| NPI Enumeration Date: | 07/15/2014 |
| NPI Last Update Date: | 11/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2014023848 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |