Provider Demographics
NPI:1609057470
Name:JOHN D ARSEN DPM INC
Entity Type:Organization
Organization Name:JOHN D ARSEN DPM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BODO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-693-7700
Mailing Address - Street 1:1251 S LAPEER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-1415
Mailing Address - Country:US
Mailing Address - Phone:248-693-7700
Mailing Address - Fax:248-693-3032
Practice Address - Street 1:1251 S LAPEER RD STE 101
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1415
Practice Address - Country:US
Practice Address - Phone:248-693-7700
Practice Address - Fax:248-693-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJA400164213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P53720Medicare PIN
MI5806010001Medicare NSC