Organization
UNIVERSITY PEDIATRIC RHEUMATOLOGY OF KENTUCKY 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
210 E GRAY ST, SUITE 1000, LOUISVILLE, KY 40202-3906
(502) 629-7702
(502) 629-3975
Mailing address
PO BOX 2469, LOUISVILLE, KY 40201-2469
(502) 852-8500
(502) 852-8556
Taxonomy
Speciality
Code
Description
License number
State
2080P0216X
Pediatric Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100040750
—
KY
Enumeration date
08/14/2007
Last updated
07/23/2008
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