Provider Demographics
NPI:1548329923
Name:LUBKIN, IRA H (MD)
Entity type:Individual
Prefix:
First Name:IRA
Middle Name:H
Last Name:LUBKIN
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:PO BOX 1210
Mailing Address - Street 2:
Mailing Address - City:INTERVALE
Mailing Address - State:NH
Mailing Address - Zip Code:03845-1210
Mailing Address - Country:US
Mailing Address - Phone:603-387-0304
Mailing Address - Fax:
Practice Address - Street 1:80 HIGHLAND ST
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3235
Practice Address - Country:US
Practice Address - Phone:603-524-3211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9524207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0108801Y0NH01OtherBCBS
NH930050638OtherRAILROAD MCARE
NH30009963Medicaid
NH930050638OtherRAILROAD MCARE
NH930050638OtherRAILROAD MCARE
NH30009963Medicaid
NH0108801Y0NH01OtherBCBS
NHRE4241Medicare ID - Type Unspecified
NHRE424102Medicare PIN