Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 25308 | WV |
Y | 2080P0214X | Pediatric Pulmonologist | 55113 | TN |
NPI | 1679546196 |
---|---|
Provider Name | Dr. Patricia Jean Dubin |
First Address | Memphis, TN 38105-4607 |
Second Address | Memphis, TN 38105-4625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 19/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001951836 | (05) | PA |
H82312 | (02) | PA |
Q025791 | (05) | TN |