Basic Information
| Provider Information | |||||||||
| NPI: | 1376598086 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUBENSTEIN | ||||||||
| FirstName: | HOWARD | ||||||||
| MiddleName: | JAY | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 960 INDUSTRIAL PKWY STE B | ||||||||
| Address2: | |||||||||
| City: | SARALAND | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365713746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514145900 | ||||||||
| FaxNumber: | 2514458859 | ||||||||
| Practice Location | |||||||||
| Address1: | 960 INDUSTRIAL PKWY STE B | ||||||||
| Address2: | |||||||||
| City: | SARALAND | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365713746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514145900 | ||||||||
| FaxNumber: | 2514458859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 05/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 00010612 | AL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 009937236 | 05 | AL | MEDICAID | 07189347 | 05 | MS | MEDICAID |