Provider Demographics
NPI:1811995756
Name:HART, DUBLIN J (DC)
Entity type:Individual
Prefix:
First Name:DUBLIN
Middle Name:J
Last Name:HART
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 US HIGHWAY 395 N STE 7
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-4318
Mailing Address - Country:US
Mailing Address - Phone:775-575-7311
Mailing Address - Fax:775-772-3008
Practice Address - Street 1:1685 US HIGHWAY 395 N STE 7
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4318
Practice Address - Country:US
Practice Address - Phone:775-575-7311
Practice Address - Fax:775-772-3008
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21353111N00000X
NVB-00468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV350045434OtherRAILROAD MEDICARE
NVB-00468OtherNV LICENSE #
NVB-00468OtherNV LICENSE #
NVU37489Medicare UPIN