1467596585 NPI number — DUBIN ORTHOPAEDIC CENTRE, P.S.C.

Table of content: (NPI 1467596585)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467596585 NPI number — DUBIN ORTHOPAEDIC CENTRE, P.S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUBIN ORTHOPAEDIC CENTRE, P.S.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467596585
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
705 N 12TH ST STE 100
Provider Second Line Business Mailing Address:
PO BOX 2897
Provider Business Mailing Address City Name:
MIDDLESBORO
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40965-1835
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-248-0050
Provider Business Mailing Address Fax Number:
606-248-8711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 N 12TH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
MIDDLESBORO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40965-1835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-248-0050
Provider Business Practice Location Address Fax Number:
606-248-8711
Provider Enumeration Date:
02/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DUBIN
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
606-248-0050

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  25458 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363AM0700X , with the licence number: PA679 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1359761 . This is a "UMWA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 163844200 . This is a "DEPT OF LABOR" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 085617 . This is a "VA BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50009243 . This is a "PHP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 95001780 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000505007 . This is a "A. JONES, PA-C IND ID#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 6410111 . This is a "VA MEDICAID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000048909 . This is a "R. DUBIN, M.D. IND ID#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 90004839 . This is a "KY MEDICAID DME" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64254584 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000059556 . This is a "BCBS GRP #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00196 . This is a "MEDICARE GROUP#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00196002 . This is a "MEDICARE PIN #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 4409001 . This is a "TN MEDICAID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0067174 . This is a "TN BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1467596585 . This is a "MEDICARE RAILROAD GROUP NPI" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200033474 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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