Provider Demographics
NPI:1043303373
Name:VERGHIS, ARUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUL
Middle Name:
Last Name:VERGHIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 CHURCHMAN AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-1190
Mailing Address - Country:US
Mailing Address - Phone:502-366-7317
Mailing Address - Fax:502-366-7318
Practice Address - Street 1:4402 CHURCHMAN AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1190
Practice Address - Country:US
Practice Address - Phone:502-366-7317
Practice Address - Fax:502-366-7318
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35305207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000267046OtherANTHEM BCBS
0007538298OtherAETNA
KY64060353Medicaid
1171334OtherPASSPORT
P00162441OtherMEDICARE RAILROAD
000000267046OtherKY STATE DISTRICT CO
000000267046OtherONE NATION BENEFIT
244079000OtherPASSPORT ADVANTAGE
64060353OtherKENPAC
000000267046OtherUNICARE
000000267046OtherKY ACCESS
40090922000OtherHEALTH MANAGEMENT CO
C3647401OtherHUMANA
1171334OtherPASSPORT
KY64060353Medicaid