Provider Demographics
NPI:1780778019
Name:RUBIN, DAVID A (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:151 LAFAYETTE DR STE 401
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6864
Mailing Address - Country:US
Mailing Address - Phone:888-343-6337
Mailing Address - Fax:658-481-0921
Practice Address - Street 1:750 OLD HICKORY BLVD STE 1-260
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4528
Practice Address - Country:US
Practice Address - Phone:615-376-7500
Practice Address - Fax:615-376-7575
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO1152742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209811207Medicaid
ILENROLLEDMedicaid
MO209811207Medicaid
MO375010377Medicare PIN