# UNIVERSITY PEDIATRIC RHEUMATOLOGY OF KENTUCKY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619169612
- **Authorized official:** DR. GERARD P. RABALAIS MD (CHAIRMAN)
- **Authorized official phone:** (502) 852-8600

## Contact information

- **Practice address:** 210 E GRAY ST, SUITE 1000, LOUISVILLE, KY 40202-3906
- **Practice address phone:** (502) 629-7702
- **Practice address fax:** (502) 629-3975
- **Mailing address:** PO BOX 2469, LOUISVILLE, KY 40201-2469
- **Mailing address phone:** (502) 852-8500
- **Mailing address fax:** (502) 852-8556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0216X | Pediatric Rheumatology Physician | — | NULL | Yes |
| 2080P0216X | Pediatric Rheumatology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/14/2007
- **Last updated:** 07/23/2008