Provider Demographics
NPI:1154705200
Name:TUBRE, DUSTIN J (MD)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:J
Last Name:TUBRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:318-235-4543
Mailing Address - Fax:
Practice Address - Street 1:1 MERCY LN STE 201
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6457
Practice Address - Country:US
Practice Address - Phone:501-609-2229
Practice Address - Fax:501-623-0921
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NETEP7573208600000X
RIMD17112208600000X
ARE-15257208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery