Healthcare Provider Details

I. General information

NPI: 1700504461
Provider Name (Legal Business Name): ARTHUR G HURST JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3242 E MAIN ST
COLUMBUS OH
43213-3807
US

IV. Provider business mailing address

3242 E MAIN ST
COLUMBUS OH
43213-3807
US

V. Phone/Fax

Practice location:
  • Phone: 614-500-4150
  • Fax:
Mailing address:
  • Phone: 614-500-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: