| Doctor Name: | MR. CRAIG DOUGLAS ROUBEN |
| NPI Number: | 1043562267 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 3007663 |
| Business Practice Address: | 2100 Market St Charlestown, IN - 471119535 |
| Business Phone Number: | 8122469809 |
| Business Fax Number: | 7705739513 |
| Mailing Address: | 2100 Market St, CHARLESTOWN |
| State: | IN |
| Postal Code: | 471119535 |
| Phone Number: | 8122469809 |
| Fax Number: | 7705739513 |
| NPI Enumeration Date: | 10/11/2012 |
| NPI Last Update Date: | 10/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3007663 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |