Healthcare Provider Details

I. General information

NPI: 1316706971
Provider Name (Legal Business Name): ARTHUR MAKHOUL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-7474
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-0001
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6203
  • Fax: 570-271-5976
Mailing address:
  • Phone: 570-271-6203
  • Fax: 570-271-5976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberOT024548
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: