Provider Demographics
NPI:1538162490
Name:HUBBS, EMILY (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HUBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:MORAWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37662-0009
Mailing Address - Country:US
Mailing Address - Phone:423-857-2066
Mailing Address - Fax:423-857-2070
Practice Address - Street 1:105 W STONE DR
Practice Address - Street 2:STE 3A
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3256
Practice Address - Country:US
Practice Address - Phone:423-323-6200
Practice Address - Fax:423-323-6593
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231490207Q00000X
TNMD 36817207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3879700Medicaid
VA005646758Medicaid
VA5646766Medicaid
TNCA5023Medicare PIN
TN3879700Medicare ID - Type Unspecified
VA5646766Medicaid
TN0281780001Medicare PIN
TN3700592Medicare UPIN
TN0281780003Medicare PIN
TN3879700Medicaid
VA005646758Medicaid