Healthcare Provider Details

I. General information

NPI: 1851449425
Provider Name (Legal Business Name): TRISTATE ARTHRITIS & RHEUMATOLOGY PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 LEGENDS WAY
CRESTVIEW HILLS KY
41017-2418
US

IV. Provider business mailing address

2616 LEGENDS WAY
CRESTVIEW HILLS KY
41017-2418
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-3100
  • Fax: 859-331-9147
Mailing address:
  • Phone: 859-331-3100
  • Fax: 859-331-9147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTHUR M KUNATH
Title or Position: PRESIDENT
Credential:
Phone: 859-331-3100