Provider Demographics
NPI:1922183771
Name:ARYA, KANTA (MD)
Entity Type:Individual
Prefix:MS
First Name:KANTA
Middle Name:
Last Name:ARYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 3L
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701
Mailing Address - Country:US
Mailing Address - Phone:606-439-1815
Mailing Address - Fax:606-436-5021
Practice Address - Street 1:200 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 3L
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701
Practice Address - Country:US
Practice Address - Phone:606-439-1815
Practice Address - Fax:606-436-5021
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22947208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000041977OtherANTHEM BCBS
KY64229479Medicaid
KY000000001603OtherCHA HEALTH
C74939Medicare UPIN