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General NPI Number Information
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NPI Number | 1912206616
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Entity Type | Organization
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Legal Business Name | JEFFERY M. REUBEN, MD PA
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 40 OKATIE CENTER BLVD S STE 350
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City | OKATIE
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State | SC
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Zip | 29909-7511
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Country | US
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Telephone | 843-379-7746
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Fax | 843-522-1275
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Provider Business Mailing Address
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Address Line | PO BOX 670
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City | PORT ROYAL
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State | SC
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Zip | 29935-0670
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Country | US
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Telephone | 843-379-7746
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Fax | 843-522-1275
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFERY M REUBEN
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Credential | MD
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Telephone | 843-379-7746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | TL30979
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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