Organization
RUBIS PLASTIC SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT A. RUBIS MD (OWNER)
(918) 254-6793
Entity
Organization
Contact information
Practice address
10119 E 80TH ST, SUITE A, TULSA, OK 74133-3407
(918) 254-6793
(918) 254-6796
Mailing address
10119-A EAST 80TH STREET SOUTH, TULSA, OK 74133
(918) 254-6793
(918) 254-6796
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
21510
OK
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
21510
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100749040A
—
OK
Enumeration date
12/21/2006
Last updated
06/18/2013
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