Provider Demographics
NPI:1447360698
Name:RUBENSTEIN, LAURENCE Z (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:Z
Last Name:RUBENSTEIN
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Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:1122 NE 13TH ST # 1200
Mailing Address - Street 2:REYNOLDS DEPARTMENT OF GERIATRIC MEDICINE
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1039
Mailing Address - Country:US
Mailing Address - Phone:405-271-8124
Mailing Address - Fax:405-271-3887
Practice Address - Street 1:1122 NE 13TH ST STE 150
Practice Address - Street 2:OU SENIOR HEALTH CENTER
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1039
Practice Address - Country:US
Practice Address - Phone:405-271-3050
Practice Address - Fax:405-271-3887
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2014-09-17
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Provider Licenses
StateLicense IDTaxonomies
OK27943207RG0300X
CAG32738207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91472Medicare UPIN