Organization Active NPI

John G Kublin MD PC

  • Ophthalmology Physician
  • Marquette, MI
National Provider Identifier
1124151410
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
JK024282 Issued in MI
Legal business name
JOHN G KUBLIN MD PC
Practice address
1414 W Fair Ave
Suite 150
Marquette, MI 49855-2675
Phone
(906) 226-2531
Fax
(906) 226-7555
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John G Kublin, MD
Title
President
Phone
(906) 226-2531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X JK024282 MI Primary

Addresses

Primary practice location

1414 W Fair Ave
Suite 150
Marquette, MI 49855-2675

Mailing address

1414 W Fair Ave
Suite 150
Marquette, MI 49855-2675
Phone (906) 226-2531

Other identifiers 2

IdentifierTypeStateIssuer
2018470MedicaidMI
1805249991OtherMIBLUE CROSS

National Provider Directory

National Provider Directory

Locations

1414 W Fair Ave
Ste 150
Marquette, MI 49855
Phone (906) 226-2531

1414 W Fair Ave
Marquette, MI 49855
Phone (906) 225-3880

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1124151410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 150",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-226-2531",
            "fax_number": "906-226-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 150",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-226-2531",
            "fax_number": "906-226-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN G KUBLIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "KUBLIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-226-2531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "JK024282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018470",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1805249991",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.