Provider Demographics
NPI:1861445298
Name:RUBIO, FELIPE A (MD)
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:A
Last Name:RUBIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 826
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-0826
Mailing Address - Country:US
Mailing Address - Phone:937-396-1605
Mailing Address - Fax:888-368-2122
Practice Address - Street 1:3080 ACKERMAN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3555
Practice Address - Country:US
Practice Address - Phone:937-396-1605
Practice Address - Fax:888-368-2122
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH48712207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRU0531125Medicare PIN