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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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