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Organization
UNIVERSITY PEDIATRICS INFECTIOUS DISEASES, LLC
Active
Organization
UNIVERSITY PEDIATRICS INFECTIOUS DISEASES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARD P RABALAIS M.D. (PRESIDENT)
(502) 852-8500
Entity
Organization
Contact information
Practice address
210 E GRAY ST, SUITE 802, LOUISVILLE, KY 40202-3904
(502) 852-8632
(502) 852-3939
Mailing address
PO BOX 2469, LOUISVILLE, KY 40201-2469
(502) 852-8500
(502) 852-8556
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080P0208X
Pediatric Infectious Diseases Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200890640A
—
IN
05
—
7100013510
—
KY
Enumeration date
02/26/2007
Last updated
12/07/2009
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