MEDICARE: DR. PAUL MICHAEL HRUBY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	5622	NE
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	E9102	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174729016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL MICHAEL HRUBY M.D.

Provider Business Mailing Address
First Line	:	1524 CUMING ST APT 501
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68102-4436
Country	:	US
Telephone Number	:	402-321-1146
Fax Number	:

Provider Business Practice Location Address
First Line	:	9800 BAPTIST HEALTH DR STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-6243
Country	:	US
Telephone Number	:	501-219-0900
Fax Number	:	501-312-4750

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	04/08/2019

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