Provider Demographics
NPI:1063603975
Name:RUBENSTEIN, JASON (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:ELECTROPHYSIOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6000
Mailing Address - Fax:414-805-6280
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:ELECTROPHYSIOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6000
Practice Address - Fax:414-805-6280
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI52321-020207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1063603975Medicaid