Healthcare Provider Details

I. General information

NPI: 1548236946
Provider Name (Legal Business Name): RALPH RAINER BOHN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 DIXIE HWY
LOUISVILLE KY
40210-2311
US

IV. Provider business mailing address

12017 BROOKMOOR DR
LOUISVILLE KY
40243-2051
US

V. Phone/Fax

Practice location:
  • Phone: 502-774-3133
  • Fax:
Mailing address:
  • Phone: 502-244-0705
  • Fax: 502-244-3247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberKY175
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberKY175
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: