Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 19550 | KY |
NPI | 1316942006 |
---|---|
Provider Name | Dr. David P Rouben |
First Address | Louisville, KY 40215-1164 |
Second Address | Louisville, KY 40220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 20/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64195506 | (05) | KY |
D30658 | (02) | KY |