Provider Demographics
NPI:1083146393
Name:DUBOIS, THOMAS FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANCIS
Last Name:DUBOIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 DELAFIELD ST STE 115
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3487
Mailing Address - Country:US
Mailing Address - Phone:262-542-2536
Mailing Address - Fax:
Practice Address - Street 1:1111 DELAFIELD ST STE 115
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3487
Practice Address - Country:US
Practice Address - Phone:262-542-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI70256-202080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine