Healthcare Provider Details

I. General information

NPI: 1861468225
Provider Name (Legal Business Name): ARLENE E BARTHELS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SIXTH ST SW
CANTON OH
44710-1702
US

IV. Provider business mailing address

2600 SIXTH ST SW
CANTON OH
44710-1702
US

V. Phone/Fax

Practice location:
  • Phone: 330-456-2695
  • Fax: 330-363-5380
Mailing address:
  • Phone: 330-456-2695
  • Fax: 330-363-5380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number698
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: