=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376565648
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA CHRISTINE DOUBLER MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2006
-----------------------------------------------------
Last Update Date | 03/13/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5319 HOAG DR
-----------------------------------------------------
City | SHEFFIELD VILLAGE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44035-1494
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-930-6050
-----------------------------------------------------
Fax | 440-934-8882
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7001 S EDGERTON RD STE A
-----------------------------------------------------
City | BRECKSVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44141-4206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-717-0591
-----------------------------------------------------
Fax | 440-717-0594
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 35-083608R
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------