Healthcare Provider Details

I. General information

NPI: 1184718512
Provider Name (Legal Business Name): RUBENSTEIN FAMILY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1084 INDUSTRIAL PARKWAY SUITE C
SARALAND AL
36571-3725
US

IV. Provider business mailing address

1084 INDUSTRIAL PARKWAY SUITE C
SARALAND AL
36571-3725
US

V. Phone/Fax

Practice location:
  • Phone: 251-675-5034
  • Fax: 251-675-8511
Mailing address:
  • Phone: 251-675-5034
  • Fax: 251-675-8511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberMD10612
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberMD10612
License Number State

VIII. Authorized Official

Name: HOWARD J RUBENSTEIN
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 251-675-5034