Provider Demographics
NPI:1558446765
Name:ARTHUR, KIERSTEN W (MD)
Entity type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:W
Last Name:ARTHUR
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:ERIE AVE AT FRONT STREET
Mailing Address - Street 2:SUITE 133-1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-1095
Mailing Address - Country:US
Mailing Address - Phone:215-427-3131
Mailing Address - Fax:215-427-8782
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-4579
Practice Address - Fax:614-722-4565
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086091207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8711704Medicaid
OH8711704Medicaid
OHH40698Medicare UPIN