Provider Demographics
NPI:1326641846
Name:ARTHUR, JOAN
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:ARTHUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 STATE ROUTE 774
Mailing Address - Street 2:
Mailing Address - City:HAMERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45130-9615
Mailing Address - Country:US
Mailing Address - Phone:513-673-2308
Mailing Address - Fax:
Practice Address - Street 1:1776 STATE ROUTE 774
Practice Address - Street 2:
Practice Address - City:HAMERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45130-9615
Practice Address - Country:US
Practice Address - Phone:513-673-2308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH005-272-4Medicaid