Provider Demographics
NPI:1770510786
Name:AROON, JAVALI B (MD)
Entity Type:Individual
Prefix:
First Name:JAVALI
Middle Name:B
Last Name:AROON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:627 W FOURTH ST
Mailing Address - Street 2:EASTERN STATE HOSPITAL
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1294
Mailing Address - Country:US
Mailing Address - Phone:859-246-7000
Mailing Address - Fax:859-246-7023
Practice Address - Street 1:627 W FOURTH ST
Practice Address - Street 2:EASTERN STATE HOSPITAL
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1294
Practice Address - Country:US
Practice Address - Phone:859-246-7000
Practice Address - Fax:859-246-7023
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY185742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18574Medicaid
KY260026998OtherRR MEDICARE
KY18574Medicaid
3341031Medicare PIN