Provider Demographics
NPI:1184603474
Name:RUBIN, WILLIAM S (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:1930 BISHOP LN
Practice Address - Street 2:SUITE 1600
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1921
Practice Address - Country:US
Practice Address - Phone:502-272-5034
Practice Address - Fax:502-272-5117
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY17709207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY100349770OtherHEALTHY INDIANA PLAN- NORTON ICC
IN100349770Medicaid
KY64177090Medicaid
KY047292OtherSIHO- NORTON ICC
KY000000480188OtherANTHEM NORTON
047292OtherSIHO - NICC
KY1054506OtherPASSPORT ID#
KYP00362332OtherRAILROAD MEDICARE
IN100349770OtherANTHEM INDIANA MEDICAID- NORTON ICC
KY000000057464OtherANTHEM PROV ID#
KY1226924OtherCHA- NORTON ICC
KY1054506OtherPASSPORT ID#
KYP00362332OtherRAILROAD MEDICARE
IN100349770Medicaid