Individual
RAUL HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1002 LEAWOOD DR, FRANKFORT, KY 40601
(502) 227-7188
(502) 227-7379
Mailing address
PO BOX 4168, FRANKFORT, KY 40601
(502) 223-5811
(502) 227-7379
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35532
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0939806
ALTERNATE MEDICARE PIN
KY
05
—
64027345
—
KY
Enumeration date
04/20/2006
Last updated
12/27/2011
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