Healthcare Provider Details

I. General information

NPI: 1629125596
Provider Name (Legal Business Name): FREDERICK VEDDER ARNDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 04/04/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-1789
US

IV. Provider business mailing address

77 MACK WALTERS RD STE 300
SHELBYVILLE KY
40065-1789
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6047
  • Fax: 859-257-3873
Mailing address:
  • Phone: 502-437-5161
  • Fax: 502-437-5163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number41829
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number41829
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number41829
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: