Individual
CARL DUBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4400 BROADWAY STE 407, KANSAS CITY, MO 64111
(816) 931-1711
(816) 932-1719
Mailing address
901 E 104TH ST, MAILSTOP 400S, KANSAS CITY, MO 64131
(816) 502-7117
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2017014862
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2014
Last updated
08/28/2018
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