Basic Information
| Provider Information | |||||||||
| NPI: | 1801329958 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUBBELL | ||||||||
| FirstName: | ALICIA | ||||||||
| MiddleName: | CLAIRE | ||||||||
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| Credential: | MD, MBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 HEALTH CENTER PKWY | ||||||||
| Address2: | |||||||||
| City: | YUKON | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730996381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057176800 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | INTEGRIS CANADIAN VALLEY HOSPITAL | ||||||||
| Address2: | 1201 HEALTH CENTER PARKWAY | ||||||||
| City: | YUKON | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730996381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8179961725 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2017 | ||||||||
| LastUpdateDate: | 06/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35491 | OK | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | S8575 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | S8575 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 35491 | OK | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.