Provider Demographics
NPI:1184600033
Name:DUBIN PC, H N (OD)
Entity type:Individual
Prefix:
First Name:H
Middle Name:N
Last Name:DUBIN PC
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7130 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-2962
Mailing Address - Country:US
Mailing Address - Phone:918-252-0438
Mailing Address - Fax:918-250-0422
Practice Address - Street 1:7130 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-2962
Practice Address - Country:US
Practice Address - Phone:918-252-0438
Practice Address - Fax:918-250-0422
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK907152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT40425Medicare UPIN
OK0830950001Medicare NSC