Provider Demographics
NPI:1760478523
Name:DUBIN, RONALD S (MD)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:S
Last Name:DUBIN
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:PO BOX 2897
Mailing Address - Street 2:705 N 12TH STREET STE 100
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1835
Mailing Address - Country:US
Mailing Address - Phone:606-248-0050
Mailing Address - Fax:606-248-8711
Practice Address - Street 1:705 N 12TH STREET
Practice Address - Street 2:STE 100
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1835
Practice Address - Country:US
Practice Address - Phone:606-248-0050
Practice Address - Fax:606-248-8711
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25458207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64254584Medicaid
KYC76013Medicare UPIN
KY1446802Medicare ID - Type Unspecified
KY00196002Medicare PIN