Individual
SHELLY MITCHELL RAKUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 636-7449
(502) 636-7950
Mailing address
PO BOX 950195, DEPT 86236, LOUISVILLE, KY 40295-0195
(502) 473-2100
(502) 459-6461
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28051
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64280514
—
KY
Enumeration date
12/29/2005
Last updated
10/11/2007
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