DR. JUSTIN F BUBOLZ M.D.
NPI 1962481630
Pediatrics in Hannibal, MO

Q: What is Justin Bubolz's NPI number?

The NPI number for Justin Bubolz is 1962481630. It was assigned to this individual provider in the NPPES registry on January 11, 2006.

Q: What is Justin Bubolz's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Justin Bubolz was last updated on October 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 11, 2006

100 MEDICAL DR, HANNIBAL, MO 63401(573) 231-3102(573) 231-3723 Get Directions Write a Review

NPPES record last updated: October 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 8, 2021, Feb 14, 2021 (2 updates tracked since 2021).

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About Dr. Justin F Bubolz M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JUSTIN F BUBOLZ M.D. (NPI 1962481630) is an individual pediatrics provider in Hannibal, Missouri, licensed in Missouri (R2H02) and active in the NPI registry since January 2006.

NPPES Registry Identity

NPI1962481630

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. JUSTIN F BUBOLZCredential: M.D.

Location Address100 MEDICAL DRHannibal, MO 63401-6877

Mailing Address100 Medical DrHannibal, MO 63401-6877 · (573) 231-3102 · Fax (573) 231-3723

Phone(573) 231-3102

Fax(573) 231-3723

Sole ProprietorNo

Enumeration DateJanuary 11, 2006

Last NPPES UpdateOctober 8, 20212 updates tracked since enumeration

NPPES CertifiedOctober 8, 2021

✔ NPI 1962481630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MO · R2H02

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

100 MEDICAL DR, Hannibal, MO 63401

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Other Identifiers 1

Medicaid209722503MO

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLESSING HOSPITAL

Pharmacy (Community/Retail Pharmacy)