Provider Demographics
NPI:1134167745
Name:RUBEL, LANCE E (MD)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:E
Last Name:RUBEL
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 3276
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47731-3276
Mailing Address - Country:US
Mailing Address - Phone:812-473-0181
Mailing Address - Fax:812-473-5822
Practice Address - Street 1:1305 N ELM ST
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2783
Practice Address - Country:US
Practice Address - Phone:270-827-0353
Practice Address - Fax:270-827-4966
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039695A207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100334480Medicaid
IN000000065507OtherBLUE SHIELD
050066922OtherRAILROAD MEDICARE
KY64873417Medicaid
050066922OtherRAILROAD MEDICARE
533670SMedicare ID - Type Unspecified