Organization
RIVER CITY ORTHOPAEDIC SURGEONS, PSC
Active
Organization
RIVER CITY ORTHOPAEDIC SURGEONS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID P ROUBEN MD (CORPORATE OFFICER)
(502) 935-8061
Entity
Organization
Contact information
Practice address
9300 STONESTREET RD, SUITE 200, LOUISVILLE, KY 40272-2876
(502) 935-8061
(502) 933-7010
Mailing address
9300 STONESTREET RD, SUITE 200, LOUISVILLE, KY 40272-2876
(502) 935-8061
(502) 933-7010
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083879
PASSPORT
KY
01
—
3435655000
PASSPORT ADVANTAGE
KY
05
—
65922528
—
KY
01
—
CL1931
RAILROAD MEDICARE
KY
Enumeration date
12/18/2006
Last updated
10/21/2011
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