MEDICARE: DR. ARTHUR LYAKHOVETSKY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0805X	Geriatric Psychiatry Physician	01042262B	IN
2	2084P0805X	Geriatric Psychiatry Physician	01047262A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000183814	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1124097142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR LYAKHOVETSKY MD

Provider Business Mailing Address
First Line	:	1410 BALLOU RD
Second Line	:
City	:	FLOYDS KNOBS
State	:	IN
Zip	:	47119-8523
Country	:	US
Telephone Number	:	502-794-6852
Fax Number	:	877-215-4462

Provider Business Practice Location Address
First Line	:	1220 ADAMS ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-1803
Country	:	US
Telephone Number	:	317-414-7372
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	03/01/2023

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