Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 21510 | OK |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 21510 | OK |
NPI | 1326015843 |
---|---|
Provider Name | Brent Albert Rubis |
First Address | Tulsa, OK 74133-3407 |
Second Address | Tulsa, OK 74133-3407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 14/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100181350A | (05) | OK |
1323612001 | CIGNA (01) | OK |
1980515 | UNITED HEALTHCARE (01) | OK |
2542190 | AETNA (01) | OK |
7017123 | AETNA (01) | OK |
H19250 | (02) | OK |