Dubose, Kyle Justin

Dubose, Kyle Justin is an individual health care provider with primary practice located at 10400 75Th St , Kenosha WI 53142-7884. He recently has only one registered license in Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, which is considered as his primary health care specialty. Dubose, Kyle Justin can be contacted via phone (262) 942-5600.

Contact Information

Primary practice address
10400 75Th St Kenosha WI 53142-7884
Phone: (262) 942-5600
Fax: (262) 948-7388
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 2083P0011X 67393 Wisconsin

Profile Details

NPI number 1285093104
LBN Legal business name Dubose, Kyle Justin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2016
Last updated Sep 5th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285093104 NPPES
Wisconsin MEDICAID 100068480

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