Provider Demographics
NPI:1962587576
Name:SCHUBBE, JOHN D (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:SCHUBBE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S KENSINGTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915
Mailing Address - Country:US
Mailing Address - Phone:920-738-0200
Mailing Address - Fax:920-738-0383
Practice Address - Street 1:2200 S KENSINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915
Practice Address - Country:US
Practice Address - Phone:920-738-0200
Practice Address - Fax:920-738-0383
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2322012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38851300Medicaid
000235255Medicare ID - Type Unspecified
WI38851300Medicaid