Healthcare Provider Details

I. General information

NPI: 1609952662
Provider Name (Legal Business Name): JOHN S. ARTHUR MD PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2528 WHEATON WAY SUITE 101
BREMERTON WA
98310-3305
US

IV. Provider business mailing address

2528 WHEATON WAY SUITE 101
BREMERTON WA
98310-3305
US

V. Phone/Fax

Practice location:
  • Phone: 360-479-2400
  • Fax: 360-479-7149
Mailing address:
  • Phone: 360-479-2400
  • Fax: 360-479-7149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD00012160
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD00012160
License Number StateWA

VIII. Authorized Official

Name: DR. JOHN SCRIPTURE ARTHUR
Title or Position: PRESIDENT
Credential: MD
Phone: 360-479-2400