Healthcare Provider Details

I. General information

NPI: 1396910469
Provider Name (Legal Business Name): ARIHANT JAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CROSS ST
HAMILTON MO
64644-8312
US

IV. Provider business mailing address

1 CROSS ST
HAMILTON MO
64644-8312
US

V. Phone/Fax

Practice location:
  • Phone: 816-583-2151
  • Fax: 816-583-2342
Mailing address:
  • Phone: 816-583-2151
  • Fax: 816-583-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2010020746
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: