Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 00024460 | AL |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 24460 | AL |
NPI | 1346256260 |
---|---|
Provider Name | James Leslie Ruble |
First Address | Mobile, AL 36685-0489 |
Second Address | Mobile, AL 36608-9525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 03/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
125019 | (05) | AL |
511-09238 | BLUE CROSS BLUE SHIELD (01) | AL |
H56950 | (02) |