Provider Demographics
NPI:1114970480
Name:DUBIN, JON A (DO)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:A
Last Name:DUBIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-2875
Mailing Address - Fax:717-334-3921
Practice Address - Street 1:455 S WASHINGTON ST STE 12
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2516
Practice Address - Country:US
Practice Address - Phone:717-339-2875
Practice Address - Fax:717-334-3921
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABD2074665207Q00000X
PAOS006991L207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012530280003Medicaid
PA0012530280004Medicaid
PA37923OtherGEISINGER
PA001367860OtherHIGHMARK BCBS
PA141288OtherUNISON
PA1514803OtherGATEWAY
PA50010129OtherCAPITOL BCBS
E93045Medicare UPIN
PA0012530280003Medicaid
PA37923OtherGEISINGER