Provider Demographics
NPI:1316032519
Name:HUBBS, LARRY JOSEPH (ARNP)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:JOSEPH
Last Name:HUBBS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 SIR BARTON WAY STE 250
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2745
Mailing Address - Country:US
Mailing Address - Phone:859-639-0030
Mailing Address - Fax:859-639-0031
Practice Address - Street 1:2530 SIR BARTON WAY STE 250
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2745
Practice Address - Country:US
Practice Address - Phone:859-639-0030
Practice Address - Fax:859-639-0031
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0576424Medicare PIN
KY0976309Medicare PIN
KY0650723Medicare PIN