Provider Demographics
NPI:1013928449
Name:DENIS P RALEIGH MD PLLC
Entity Type:Organization
Organization Name:DENIS P RALEIGH MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:RALEIGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-614-6376
Mailing Address - Street 1:PO BOX 7365
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40257-0365
Mailing Address - Country:US
Mailing Address - Phone:502-614-6376
Mailing Address - Fax:502-614-7817
Practice Address - Street 1:2315 GREEN VALLEY RD
Practice Address - Street 2:STE 200
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4689
Practice Address - Country:US
Practice Address - Phone:502-614-6376
Practice Address - Fax:502-614-7817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65945107Medicaid
KYDE8228OtherRAILROAD MCARE KY
IN200081150Medicaid
9990Medicare ID - Type Unspecified