Provider Demographics
NPI:1770589376
Name:HALEY, ARTHUR ANDREW (OD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:ANDREW
Last Name:HALEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:399 CAMPBELLSVILLE BY PASS RD
Mailing Address - Street 2:STE 116
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-8831
Mailing Address - Country:US
Mailing Address - Phone:270-469-4393
Mailing Address - Fax:270-469-1050
Practice Address - Street 1:399 CAMPBELLSVILLE BY PASS RD
Practice Address - Street 2:STE 116
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-8831
Practice Address - Country:US
Practice Address - Phone:270-469-4393
Practice Address - Fax:270-469-1050
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1181DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
33132OtherARESIS
U17088OtherBLUEGRASS HEALTH
0957444OtherCIGNA
KY1165238OtherCHA
KY77011815Medicaid
25855OtherSPECTERA
KY0930101Medicare ID - Type Unspecified
KY77011815Medicaid