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General NPI Number Information
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NPI Number | 1598752248
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Entity Type | Individual
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Provider Name | ARA S. MAKDESSIAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 225 HOSPITAL DRIVE SUITE 265, CLARK CLINIC B
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City | WINCHESTER
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State | KY
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Zip | 40391-1156
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Country | US
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Telephone | 859-745-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 225 HOSPITAL DRIVE SUITE 265, CLARK CLINIC B
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City | WINCHESTER
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State | KY
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Zip | 40391-1156
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Country | US
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Telephone | 859-745-1010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 39412
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License Number State | KY
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