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NPI Code Detail

MEDICARE: ARVIN FAMILY PRACTICE P.S.C.

MEDICARE: ARVIN FAMILY PRACTICE P.S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician33743KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407071954
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARVIN FAMILY PRACTICE P.S.C.
Provider Business Mailing Address
First Line : 185 NEWCOMB AVE
Second Line :
City : MOUNT VERNON
State : KY
Zip : 40456-2733
Country : US
Telephone Number : 606-256-2143
Fax Number : 606-256-9762
Provider Business Practice Location Address
First Line : 185 NEWCOMB AVE
Second Line :
City : MOUNT VERNON
State : KY
Zip : 40456-2733
Country : US
Telephone Number : 606-256-2143
Fax Number : 606-256-9762
Authorized Official
Title or Position : PHYSICIAN
Name : DR. JON ANTHONY ARVIN
Credential : M.D.
Telephone Number : 606-256-2143
Provider Enumeration Date : 04/17/2007
Last Update Date : 04/04/2008

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