Provider Demographics
NPI:1518033091
Name:RUBLE, PAUL SPENCER (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SPENCER
Last Name:RUBLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 FOSTER SPROUSE RD
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-6918
Mailing Address - Country:US
Mailing Address - Phone:706-595-3806
Mailing Address - Fax:
Practice Address - Street 1:2173 FOSTER SPROUSE RD
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-6918
Practice Address - Country:US
Practice Address - Phone:706-595-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2139207L00000X
GA64754207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology