Individual
DR. RICHARD ALAN DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N ROBBINS RD, SUITE 300, BOISE, ID 83702-4565
(208) 489-4016
(208) 489-4015
Mailing address
PO BOX 1128, BOISE, ID 83701-1128
(208) 489-4016
(208) 489-4015
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
M7865
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010005570
BLUE SHIELD OF IDAHO
ID
05
—
1821156365
—
ID
01
—
185570800
US DEPT OF LABOR AND IND
ID
01
—
57430
BLUE CROSS OF IDAHO
ID
Enumeration date
12/05/2006
Last updated
01/15/2013
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