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Organization
UNIVERSITY PEDIATRIC BONE MARROW TRANSPLANT SPECIALISTS, LLC
Active
Organization
UNIVERSITY PEDIATRIC BONE MARROW TRANSPLANT SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARD P RABALAIS MD (CHAIRMAN)
(502) 852-8600
Entity
Organization
Contact information
Practice address
601 S FLOYD ST, STE. 403, LOUISVILLE, KY 40202-1835
(502) 629-7750
(502) 629-7784
Mailing address
PO BOX 2469, LOUISVILLE, KY 40201-2469
(502) 852-8500
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
NULL
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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