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General NPI Number Information
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NPI Number | 1033436282
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PEDIATRICS FOUNDATION, INC.
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Dates
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Enumeration Date | 04/28/2010
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Last Update Date | 04/28/2010
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Provider Practice Location Address
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Address Line | 9800 SHELBYVILLE RD
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City | LOUISVILLE
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State | KY
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Zip | 40223-2977
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Country | US
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Telephone | 502-629-3320
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Fax | 502-629-3975
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Provider Business Mailing Address
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Address Line | PO BOX 2469
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City | LOUISVILLE
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State | KY
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Zip | 40201-2469
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Country | US
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Telephone | 502-852-8500
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Fax | 502-852-8556
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. GERARD P. RABALAIS
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Credential | MD
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Telephone | 502-852-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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