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General NPI Number Information
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NPI Number | 1528209350
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF LOUISVILLE
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Dates
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Enumeration Date | 03/06/2009
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 555 S FLOYD ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-3822
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Country | US
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Telephone | 502-852-5588
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Fax | 502-852-5630
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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 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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 29710
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License Number State | KY
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