Provider Demographics
NPI:1326120353
Name:RHEUBLE, WILLIAM DAVID I (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:RHEUBLE
Suffix:I
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 1:4760 W US 40
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374
Mailing Address - Country:US
Mailing Address - Phone:765-965-6679
Mailing Address - Fax:765-939-2892
Practice Address - Street 1:4760 W US 40
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374
Practice Address - Country:US
Practice Address - Phone:765-965-6679
Practice Address - Fax:765-939-2892
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034479207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100471010AMedicaid
IN000000092104OtherANTHEM BCBS PROVIDER NUM
IN000000092104OtherANTHEM BCBS PROVIDER NUM
IN100471010AMedicaid