Provider Demographics
NPI:1649601725
Name:DUBIN ORTHOPEDIC CENTRE PSC
Entity Type:Organization
Organization Name:DUBIN ORTHOPEDIC CENTRE PSC
Other - Org Name:BROWNSTONE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-248-0050
Mailing Address - Street 1:705 N 12TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-2067
Mailing Address - Country:US
Mailing Address - Phone:606-248-0050
Mailing Address - Fax:
Practice Address - Street 1:705 N 12TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2067
Practice Address - Country:US
Practice Address - Phone:606-248-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUBIN ORTHOPEDIC CENTRE PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-27
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1077003363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty