Provider Demographics
NPI:1942412168
Name:GERALD A. RAHN, MD., LLC
Entity Type:Organization
Organization Name:GERALD A. RAHN, MD., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-334-1333
Mailing Address - Street 1:417 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-3915
Mailing Address - Country:US
Mailing Address - Phone:812-334-1333
Mailing Address - Fax:812-334-1444
Practice Address - Street 1:822 W 1ST ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2384
Practice Address - Country:US
Practice Address - Phone:812-337-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031820207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000507206OtherBCBS
IN1225060940OtherINDIVIDUAL NPI
IN5846260001Medicare NSC
IN000000507206OtherBCBS
INB29183Medicare UPIN