Provider Demographics
NPI:1427002203
Name:KUBLIN, JOHN G (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:KUBLIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1414 W FAIR AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2675
Mailing Address - Country:US
Mailing Address - Phone:906-226-2531
Mailing Address - Fax:906-226-7555
Practice Address - Street 1:1414 W FAIR AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2675
Practice Address - Country:US
Practice Address - Phone:906-226-2531
Practice Address - Fax:906-226-7555
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2009-12-29
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Provider Licenses
StateLicense IDTaxonomies
MIJK024282207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2018470Medicaid
MI180524991OtherBLUE CROSS
MIP43000001Medicare PIN
MI180524991OtherBLUE CROSS