Provider Demographics
NPI:1902195845
Name:RAUCCI, FRANK JOSEPH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOSEPH
Last Name:RAUCCI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:JOSEPH
Other - Last Name:RAUCCI
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:2200 CHILDRENS WAY STE 5230
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0005
Mailing Address - Country:US
Mailing Address - Phone:615-322-7447
Mailing Address - Fax:615-322-2210
Practice Address - Street 1:2200 CHILDRENS WAY STE 5230
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0005
Practice Address - Country:US
Practice Address - Phone:615-322-7447
Practice Address - Fax:615-322-2210
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46884208000000X
390200000X
TN526312080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY165902OtherSIHO-NICC
KY7100310160Medicaid
KY000000886802OtherANTHEM-NICC
KY000000886802OtherANTHEM-NICC