Healthcare Provider Details

I. General information

NPI: 1558335265
Provider Name (Legal Business Name): PAUL J ARENA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LIBERTY ST SUITE 500
LOUISVILLE KY
40202-1434
US

IV. Provider business mailing address

100 E LIBERTY ST SUITE 500
LOUISVILLE KY
40202-1434
US

V. Phone/Fax

Practice location:
  • Phone: 502-561-8200
  • Fax:
Mailing address:
  • Phone: 502-561-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number15795
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number01039312A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: