Provider Demographics
NPI:1851374540
Name:QUITO, ARTURO L (MD)
Entity Type:Individual
Prefix:MR
First Name:ARTURO
Middle Name:L
Last Name:QUITO
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 429
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37367-0429
Mailing Address - Country:US
Mailing Address - Phone:423-447-6843
Mailing Address - Fax:423-447-2405
Practice Address - Street 1:3062 MAIN ST
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367-5746
Practice Address - Country:US
Practice Address - Phone:423-447-6843
Practice Address - Fax:423-447-2405
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD13761208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3189092Medicaid
TN3383849Medicaid
B04367Medicare UPIN
TN3383849Medicare ID - Type UnspecifiedGROUP
TN3383849Medicaid