MEDICARE: WILLIAM S RUBIN 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	207P00000X	Emergency Medicine Physician	17709	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00362332	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100349770	OTHER	KY	HEALTHY INDIANA PLAN- NORTON ICC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	047292	OTHER	KY	SIHO- NORTON ICC
5	000000480188	OTHER	KY	ANTHEM NORTON
6	047292	OTHER		SIHO - NICC
7	1054506	OTHER	KY	PASSPORT ID#
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	000000057464	OTHER	KY	ANTHEM PROV ID#
11	1226924	OTHER	KY	CHA- NORTON ICC

General Provider Information

NPI Number	:	1184603474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM S RUBIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 776351
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6351
Country	:	US
Telephone Number	:	502-588-9490
Fax Number	:	502-272-5116

Provider Business Practice Location Address
First Line	:	1930 BISHOP LN
Second Line	:	SUITE 1600
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-1921
Country	:	US
Telephone Number	:	502-272-5034
Fax Number	:	502-272-5117

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

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	01/21/2021

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Directions to “ WILLIAM S RUBIN M.D.” Practice Location

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