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Organization
UNIVERSITY OF LOUISVILLE
Active
Organization
UNIVERSITY OF LOUISVILLE
Active
Other names
Children and Youth Project-Adolescent Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARD RABALAIS MD (CHAIRMAN)
(502) 852-8600
Entity
Organization
Contact information
Practice address
555 S FLOYD ST, LOUISVILLE, KY 40202-3822
(502) 852-5588
(502) 852-5630
Mailing address
PO BOX 2469, LOUISVILLE, KY 40201-2469
(502) 852-8500
(502) 852-8556
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
29710
KY
Other
Enumeration date
03/06/2009
Last updated
07/09/2012
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