Healthcare Provider Details

I. General information

NPI: 1053990648
Provider Name (Legal Business Name): JOHN ROUBIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 PARK ST
HYANNIS MA
02601-5230
US

IV. Provider business mailing address

27 PARK ST
HYANNIS MA
02601-5230
US

V. Phone/Fax

Practice location:
  • Phone: 508-862-5300
  • Fax: 508-790-4565
Mailing address:
  • Phone: 508-862-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number0116037045
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: