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DR. GREGORY VAN DUBAY DPM
Foot Surgery >> Podiatrist >> Podiatric Medicine & Surgery Service ProvidersRegistrant NPI Number: 1720146954
Individual Registrant:DR. GREGORY VAN DUBAY DPM
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
875 FRIENDSHIP RD STE J TALLASSEE, AL 36078-1256 US
Tel: 334-283-4178 Fax: 334-283-2190
Tel: 334-283-4178 Fax: 334-283-2190
Contact information for business:
PO BOX 780367 TALLASSEE, AL 36078-0004 US
Tel: 334-283-4178 Fax: 334-283-2190
Tel: 334-283-4178 Fax: 334-283-2190
Registration Information:
NPI: 1720146954
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 213ES0131X | Podiatric Medicine & Surgery Service Providers Podiatrist Foot Surgery | AL | AL71 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 051552056 | AL | 05 | |
| BCBSAL | 515-12528 | AL | 01 |
| MEDICARE PROVIDER | 051552056 | AL | 01 |
| GROUP NPI | 1841468238 | AL | 01 |
