Provider Demographics
NPI:1841354172
Name:VANARSDALL, JOHN AARON II (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:AARON
Last Name:VANARSDALL
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:6801 DIXIE HWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3913
Mailing Address - Country:US
Mailing Address - Phone:502-589-3844
Mailing Address - Fax:502-589-0516
Practice Address - Street 1:201 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 904
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3841
Practice Address - Country:US
Practice Address - Phone:502-589-3844
Practice Address - Fax:502-589-0516
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2014-07-15
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Provider Licenses
StateLicense IDTaxonomies
KY18569207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64185697Medicaid
KY64185697Medicaid
KY0608503Medicare ID - Type Unspecified
KYK026111Medicare PIN