Provider Demographics
NPI:1437133840
Name:RABALAIS, GERARD PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:PAUL
Last Name:RABALAIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 776879
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6879
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:210 E GRAY ST
Practice Address - Street 2:STE 802
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3904
Practice Address - Country:US
Practice Address - Phone:502-588-2348
Practice Address - Fax:502-588-2334
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2021-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY25426208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64254265Medicaid
IN100376310Medicaid
IN100376310Medicaid
KYP400035111Medicare PIN