Provider Demographics
NPI:1598013724
Name:TRASK, ARTHUR L (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:L
Last Name:TRASK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1630 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-2819
Mailing Address - Country:US
Mailing Address - Phone:417-837-1504
Mailing Address - Fax:417-837-1545
Practice Address - Street 1:1630 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-2819
Practice Address - Country:US
Practice Address - Phone:417-837-1504
Practice Address - Fax:417-837-1545
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO28234208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice