Individual
JAMES H GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 HOSPITAL RD, TELL CITY, IN 47586-2750
(812) 547-0117
Mailing address
303 NW 11TH ST, FAIRFIELD, IL 62837-1203
(618) 847-8243
(618) 847-8387
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01045417A
IN
207P00000X
Emergency Medicine Physician
40685
KY
207Q00000X
Family Medicine Physician
Primary
01045417
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000594472
BLUE SHIELD
IN
05
—
200173120
—
IN
Enumeration date
01/09/2006
Last updated
08/29/2016
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