Provider Demographics
NPI:1346357266
Name:ARBAUGH, LARRY R (DME PROVIDER)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:R
Last Name:ARBAUGH
Suffix:
Gender:M
Credentials:DME PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SUSAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-4951
Mailing Address - Country:US
Mailing Address - Phone:270-707-0005
Mailing Address - Fax:270-707-0013
Practice Address - Street 1:111 SUSAN AVE
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-4951
Practice Address - Country:US
Practice Address - Phone:270-707-0005
Practice Address - Fax:270-707-0013
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider