Healthcare Provider Details

I. General information

NPI: 1477886398
Provider Name (Legal Business Name): RAMESH DUBEY C.P.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2009
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 MINERAL WELLS AVE SUITE 2B
PARIS TN
38242
US

IV. Provider business mailing address

266 S CLEVELAND ST STE 102
MEMPHIS TN
38104-3520
US

V. Phone/Fax

Practice location:
  • Phone: 731-642-9984
  • Fax: 731-642-9986
Mailing address:
  • Phone: 901-590-0354
  • Fax: 901-590-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number99
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number129
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: