Provider Demographics
NPI:1942210554
Name:RIVARD, ARTHUR KENNETH JR (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:KENNETH
Last Name:RIVARD
Suffix:JR
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 1:440 WEST MARTIN L KING BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422
Mailing Address - Country:US
Mailing Address - Phone:859-236-6055
Mailing Address - Fax:859-236-6117
Practice Address - Street 1:440 WEST MARTIN L KING BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422
Practice Address - Country:US
Practice Address - Phone:859-236-6055
Practice Address - Fax:859-236-6117
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25373207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64253735Medicaid
KY000000050446OtherANTHEM BCBS
KY1502901Medicare ID - Type Unspecified
KY000000050446OtherANTHEM BCBS