Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2013021415 | MO |
NPI | 1023221231 |
---|---|
Provider Name | Jonathan Rory Dubin |
First Address | Kansas City, MO 64108-2602 |
Second Address | Kansas City, MO 64108-2727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 30/11/2020 |