=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225357809
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTIN LOENING MACARTHUR M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2010
-----------------------------------------------------
Last Update Date | 12/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1224 MAIN ST
-----------------------------------------------------
City | BRANFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06405-3778
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-481-0315
-----------------------------------------------------
Fax | 203-481-6788
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 687 MAIN ST
-----------------------------------------------------
City | BRANFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06405-3612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-481-0315
-----------------------------------------------------
Fax | 203-562-9316
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 055229
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------