Provider Demographics
NPI:1265785661
Name:ARTHUR, DUSTIN L (PT, DPT)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:L
Last Name:ARTHUR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5027 ATWOOD DR STE 2B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8322
Mailing Address - Country:US
Mailing Address - Phone:859-625-0001
Mailing Address - Fax:859-625-0057
Practice Address - Street 1:116 MERIDIAN WAY STE 9
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2876
Practice Address - Country:US
Practice Address - Phone:859-626-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006085225100000X, 2251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100235780Medicaid