Healthcare Provider Details

I. General information

NPI: 1548266976
Provider Name (Legal Business Name): DONALD RAUH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE STE D201
LEXINGTON KY
40536-6913
US

IV. Provider business mailing address

201 PARK ST
BOWLING GREEN KY
42101-1708
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-0079
  • Fax: 859-323-8173
Mailing address:
  • Phone: 270-781-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number19030
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: