| Kentucky Orthopedic Clinic | |
|
705 N 12th St Suite 100 Middlesboro KY 40965-1835 | |
| (606) 248-0050 | |
| (606) 248-8711 |
| Full Name | Kentucky Orthopedic Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 705 N 12th St, Middlesboro, Kentucky |
| Authorized Official Name and Position | Ronald S. Dubin (PRESIDENT) |
| Authorized Official Contact | 6062480050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky Orthopedic Clinic 705 N 12th St Ste 100 Po Box 2897 Middlesboro KY 40965-1835 Ph: (606) 248-0050 | Kentucky Orthopedic Clinic 705 N 12th St Suite 100 Middlesboro KY 40965-1835 Ph: (606) 248-0050 |
| NPI Number | 1467596585 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 03/28/2011 |
| Medicare PECOS PAC ID | 6103922331 |
|---|---|
| Medicare Enrollment ID | O20070505000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467596585 | NPI | - | NPPES |
| 1359761 | Other | KY | UMWA |
| 163844200 | Other | KY | DEPT OF LABOR |
| 085617 | Other | KY | VA BCBS |
| 50009243 | Other | KY | PHP |
| 95001780 | Medicaid | KY | |
| 000000505007 | Other | KY | A. JONES, PA-C IND ID# |
| 6410111 | Other | KY | VA MEDICAID |
| 000000048909 | Other | KY | R. DUBIN, M.D. IND ID# |
| 90004839 | Other | KY | KY MEDICAID DME |
| 64254584 | Medicaid | KY | |
| 000000059556 | Other | KY | BCBS GRP # |
| 00196 | Other | KY | MEDICARE GROUP# |
| 00196002 | Other | KY | MEDICARE PIN # |
| 4409001 | Other | KY | TN MEDICAID |
| 0067174 | Other | KY | TN BCBS |
| 1467596585 | Other | KY | MEDICARE RAILROAD GROUP NPI |
| 200033474 | Other | KY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 25458 (Kentucky) | Primary |
| 363AM0700X | Physician Assistant - Medical | PA679 (Kentucky) | Secondary |
| Provider Name | Ronald S Dubin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760478523 PECOS PAC ID: 7012013246 Enrollment ID: I20070625000412 |
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