Provider Demographics
NPI:1346256260
Name:RUBLE, JAMES LESLIE (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LESLIE
Last Name:RUBLE
Suffix:
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:PO BOX 850489
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-0489
Mailing Address - Country:US
Mailing Address - Phone:251-342-3949
Mailing Address - Fax:251-631-3361
Practice Address - Street 1:9971 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-9525
Practice Address - Country:US
Practice Address - Phone:251-660-3500
Practice Address - Fax:251-660-3501
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24460207QH0002X
AL00024460207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-09238OtherBLUE CROSS BLUE SHIELD
AL125019Medicaid
AL125019Medicaid
AL511-09238OtherBLUE CROSS BLUE SHIELD