Healthcare Provider Details

I. General information

NPI: 1831321876
Provider Name (Legal Business Name): KIMBERLY JOAN ARKEBAUER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY JOAN MYERS D.O.

II. Dates (important events)

Enumeration Date: 08/09/2009
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD SUITE 334
CHESTER PA
19013-3902
US

IV. Provider business mailing address

1 MEDICAL CENTER BLVD SUITE 334
CHESTER PA
19013-3902
US

V. Phone/Fax

Practice location:
  • Phone: 610-872-7660
  • Fax: 610-876-2628
Mailing address:
  • Phone: 610-872-7660
  • Fax: 610-876-2628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOT012980
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS016978
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC2-0010942
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: