Provider Demographics
NPI:1891257556
Name:UBEDA, JOEL SEBASTIAN (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:SEBASTIAN
Last Name:UBEDA
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 1:1710 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7303
Mailing Address - Country:US
Mailing Address - Phone:870-698-1846
Mailing Address - Fax:
Practice Address - Street 1:501 VIRGINIA DR STE A
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7317
Practice Address - Country:US
Practice Address - Phone:870-698-1846
Practice Address - Fax:870-793-2627
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE18112208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology