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NPI Code Detail

MEDICARE: ARNOLD D SPRAGUE III M.D.

MEDICARE: ARNOLD D SPRAGUE III M.D.
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
1207V00000XObstetrics & Gynecology Physician16000KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000299872OTHERKYANTHEM BC & BS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255308110
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARNOLD D SPRAGUE III M.D.
Provider Business Mailing Address
First Line : PO BOX 1079
Second Line :
City : HENDERSON
State : KY
Zip : 42419-1079
Country : US
Telephone Number : 270-827-0353
Fax Number : 270-827-4966
Provider Business Practice Location Address
First Line : 736 N ELM ST
Second Line :
City : HENDERSON
State : KY
Zip : 42420-2938
Country : US
Telephone Number : 270-827-4000
Fax Number : 270-827-5325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 03/21/2013

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Directions to “ ARNOLD D SPRAGUE III M.D.” Practice Location

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