David Roger Dubord, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2488-057 Issued in WI

Practice address

6001 W North Ave
Wauwatosa, WI 53213-1527

Phone

(414) 771-8110

Fax

(414) 771-7123

NPI assigned

Jul 23, 2006

Last updated

Jul 15, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1639191513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815W CAPITOL DR 314",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162056",
            "telephone_number": "414-771-8110",
            "fax_number": "414-771-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532131527",
            "telephone_number": "414-771-8110",
            "fax_number": "414-771-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBORD",
        "first_name": "DAVID",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WI",
            "license": "2488-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39768400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Dreyer, R.D., C.D.
• Robert Michael Dries, PHD
• Chris Ann Drosdick, PC, CSAC, ATR
• Karen Elaine Drzewiecki, OTR
• Christopher Dubois, FNP
• Harold Pennington Ducloux, M.D.
• Victoria Ducoffe
• Kristen L Dudas, PA-C
• Henry Joseph Duffrin, MD
• Stacy Lynn Duke

• Clinical Neuropsychologist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Clinical Neuropsychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.