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General NPI Number Information
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NPI Number | 1386057818
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Entity Type | Organization
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Legal Business Name | ADIAVNI LLC
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/24/2016
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Provider Practice Location Address
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Address Line | 280 CUMBERLAND TRACE RD APT. 417
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City | BOWLING GREEN
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State | KY
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Zip | 42103-9099
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Country | US
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Telephone | 815-220-9028
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Fax | 815-220-9028
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Provider Business Mailing Address
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Address Line | 280 CUMBERLAND TRACE RD APT. 417
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City | BOWLING GREEN
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State | KY
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Zip | 42103-9099
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Country | US
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Telephone | 815-220-9028
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Fax | 815-220-9028
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Authorized Official
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Title or Position | OWNER
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Name | ANIL ARORA
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Credential | MD
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Telephone | 815-220-9028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | KY
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