Provider Demographics
NPI:1518018209
Name:DUBAS, RICK R (DC)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:R
Last Name:DUBAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:RUSSELL
Other - Last Name:DUBAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:305 SW 7TH TERRACE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6458
Mailing Address - Country:US
Mailing Address - Phone:352-335-8008
Mailing Address - Fax:352-375-8416
Practice Address - Street 1:305 SW 7 TERRACE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6458
Practice Address - Country:US
Practice Address - Phone:352-335-8008
Practice Address - Fax:352-375-8416
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
11496537OtherCAQH
609711OtherACN
11496537OtherCAQH
609711OtherACN