Basic Information
| Provider Information | |||||||||
| NPI: | 1164646782 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUBOIS | ||||||||
| FirstName: | JANET | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5074 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571175074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053286585 | ||||||||
| FaxNumber: | 6053286512 | ||||||||
| Practice Location | |||||||||
| Address1: | 1210 W 18TH ST | ||||||||
| Address2: | STE LL03 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571044647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053281410 | ||||||||
| FaxNumber: | 6053281412 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 04/06/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 7955 | SD | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085P0229X | 7955 | SD | N | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology |
No ID Information.