Provider Demographics
NPI:1407902786
Name:MAYNARD, ARTHUR STANLEY III (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:STANLEY
Last Name:MAYNARD
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3502 WOODVIEW TRCE STE 210
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3182
Mailing Address - Country:US
Mailing Address - Phone:317-328-5050
Mailing Address - Fax:
Practice Address - Street 1:11450 N MERIDIAN ST STE 100
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4688
Practice Address - Country:US
Practice Address - Phone:317-715-9985
Practice Address - Fax:317-715-9986
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-017552085R0202X, 2085R0202X
IN01070052A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00581612Medicaid
HI00581612Medicaid