Provider Type Icon

UNIVERSITY PEDIATRIC GASTROENTEROLOGY LLC NPI 1487953311


NPI Information

NPI: 1487953311
Provider Name: UNIVERSITY PEDIATRIC GASTROENTEROLOGY, LLC
Classification: Pediatrics - 2080P0206X
Entity Type: Organization

Specialization: Pediatric Gastroenterology

Address:
720 2ND ST
STE 102
BOWLING GREEN, KY
ZIP 42101
Phone: (502) 852-7670
Get Directions

UNIVERSITY PEDIATRIC GASTROENTEROLOGY, LLC is a pediatric gastroenterology pediatrics in Bowling Green, KY. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. UNIVERSITY PEDIATRIC GASTROENTEROLOGY, LLC NPI is 1487953311. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

720 2ND ST
STE 102
BOWLING GREEN, KY
ZIP 42101-778
Phone: (502) 852-7670
Fax: (502) 852-7743

The provider's authorized official is Gerard P Rabalais .
The authorized official title is Chairman and has the following contact phone number (502) 852-8600.

The enumeration date for this NPI number is 3/17/2011 and was last updated on 4/5/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsNo
22080P0206XPediatricsPediatric GastroenterologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17100063520MEDICAIDKENTUCKY
200992MEDICARE PINKENTUCKY
3200945670MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.