Organization Name: | MEDICAL OF DUBOIS A PROFESSIONAL CORPORATION |
NPI Number: | 1184719155 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS E FIELD (PRESIDENT) |
Mailing Address: | 695 3rd Ave Jasper |
State: | IN US |
Postal Code: | 475463602 |
Phone Number: | 8126346824 |
Fax Number: | 8128482277 |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 05/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01025667 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |