Healthcare Provider Details

I. General information

NPI: 1629280656
Provider Name (Legal Business Name): ARVINDA PADMANABHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 NICHOLASVILLE RD SUITE 701
LEXINGTON KY
40503-1404
US

IV. Provider business mailing address

PO BOX 910670
LEXINGTON KY
40591-0670
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-0414
  • Fax: 859-276-3765
Mailing address:
  • Phone: 859-971-4685
  • Fax: 859-971-4602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number41739
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: