Provider Demographics
NPI:1831207067
Name:DEFINITIVE MEDICAL SOLUTIONS, PSC
Entity type:Organization
Organization Name:DEFINITIVE MEDICAL SOLUTIONS, PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-528-7200
Mailing Address - Street 1:PO BOX 1547
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65302-1547
Mailing Address - Country:US
Mailing Address - Phone:660-826-5960
Mailing Address - Fax:
Practice Address - Street 1:801 MASTER ST STE 5
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-1026
Practice Address - Country:US
Practice Address - Phone:606-528-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65916389Medicaid
KY000000059765OtherANTHEM
KYCM6708OtherRR MEDICARE
KY74903493Medicaid
KY000000059765OtherANTHEM