Individual
DR. KEVIN EARL RABEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
975 S FAIRMONT AVE, LODI, CA 95240-5118
(209) 334-3411
Mailing address
3300 RENWICK DRIVE #2053, ELK GROVE, CA 95758
(865) 684-9724
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
38717
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3329159
—
TN
01
—
4091361
BLUE CROSS
TN
01
—
4097079
BLUE CROSS
TN
Enumeration date
06/08/2006
Last updated
07/08/2007
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