Provider Demographics
NPI:1629579180
Name:ARLINGTON MEDICAL CLINIC
Entity Type:Organization
Organization Name:ARLINGTON MEDICAL CLINIC
Other - Org Name:ARLINGTON MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZETTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-251-4562
Mailing Address - Street 1:1029 MEDICAL CENTER CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-1189
Mailing Address - Country:US
Mailing Address - Phone:270-251-4562
Mailing Address - Fax:270-251-4546
Practice Address - Street 1:100 STATE ROUTE 80 E
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:KY
Practice Address - Zip Code:42021-9016
Practice Address - Country:US
Practice Address - Phone:270-267-0051
Practice Address - Fax:270-251-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31625261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center