Provider Demographics
NPI:1861367336
Name:DUBOSE, DAVID EP
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EP
Last Name:DUBOSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 SOUTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-2700
Mailing Address - Country:US
Mailing Address - Phone:513-764-9211
Mailing Address - Fax:513-829-4999
Practice Address - Street 1:5301 SOUTHVIEW DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2700
Practice Address - Country:US
Practice Address - Phone:513-764-9211
Practice Address - Fax:513-829-4999
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty