Provider Demographics
NPI:1629280656
Name:PADMANABHAN, ARVINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARVINDA
Middle Name:
Last Name:PADMANABHAN
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:PO BOX 910670
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0670
Mailing Address - Country:US
Mailing Address - Phone:859-971-4685
Mailing Address - Fax:859-971-4602
Practice Address - Street 1:1720 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 701
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1404
Practice Address - Country:US
Practice Address - Phone:859-276-0414
Practice Address - Fax:859-276-3765
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41739207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY41739OtherMEDICAL LICENSE
KY7100177380Medicaid
KY41739OtherMEDICAL LICENSE