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General NPI Number Information
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NPI Number | 1003013871
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Entity Type | Organization
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Legal Business Name | DUBIN ORTHOPAEDIC CENTRE, PSC
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 705 N 12TH ST STE 100
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City | MIDDLESBORO
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State | KY
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Zip | 40965-1835
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Country | US
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Telephone | 606-248-0050
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Fax | 606-248-8711
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Provider Business Mailing Address
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Address Line | 705 N 12TH ST STE 100 PO BOX 2897
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City | MIDDLESBORO
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State | KY
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Zip | 40965-1835
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Country | US
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Telephone | 606-248-0050
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Fax | 606-248-8711
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD SANFORD DUBIN
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Credential | M.D.
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Telephone | 606-248-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 25458
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License Number State | KY
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