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General NPI Number Information
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NPI Number | 1639830664
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Entity Type | Organization
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Legal Business Name | DUBOIS REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 01/03/2022
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 807 TURNPIKE AVE STE 120
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City | CLEARFIELD
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State | PA
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Zip | 16830-1238
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Country | US
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Telephone | 814-765-2261
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Fax | 814-765-4421
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Provider Business Mailing Address
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Address Line | 100 HOSPITAL AVE
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City | DU BOIS
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State | PA
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Zip | 15801-1440
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Country | US
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Telephone | 814-375-4200
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Fax | 814-375-4232
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Authorized Official
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Title or Position | CFO, AUTHORIZED OFFICIAL
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Name | BRIAN S KLINE
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Credential |
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Telephone | 814-375-6377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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