MEDICARE: DAVID R RAPER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	20590	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285699694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID R RAPER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 950202
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40295-0202
Country	:	US
Telephone Number	:	502-969-6552
Fax Number	:	502-969-3799

Provider Business Practice Location Address
First Line	:	234 E GRAY ST
Second Line	:	STE 334-B
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1900
Country	:	US
Telephone Number	:	502-629-1750
Fax Number	:	502-629-1760

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	07/08/2007

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Directions to “ DAVID R RAPER M.D.” Practice Location

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