Individual
ELVIN GREGORY TUBRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
(318) 251-6390
(318) 251-6390
Mailing address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
(318) 251-6390
(318) 251-6390
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
016706
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1347124
—
LA
01
—
5W9847387
MEDICARE ID
LA
Enumeration date
03/22/2006
Last updated
01/25/2010
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