Provider Demographics
NPI:1215918735
Name:HULBERT, JAMES ERNEST (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERNEST
Last Name:HULBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 TRIANGLE CTR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-4667
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 TRIANGLE CTR
Practice Address - Street 2:STE 400
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-4667
Practice Address - Country:US
Practice Address - Phone:360-423-0220
Practice Address - Fax:360-423-0697
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00011201207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1402007Medicaid
WA180011763OtherRAILROAD MEDICARE
WA1402007Medicaid
WA0634710001Medicare NSC
D33887Medicare UPIN