1104816859 NPI number — DR. RONALD EUGENE ARRICK M.D.

Table of content: JOSEPH SULLIVAN (NPI 1437497856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104816859 NPI number — DR. RONALD EUGENE ARRICK M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARRICK
Provider First Name:
RONALD
Provider Middle Name:
EUGENE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104816859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1595
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHLAND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41105-1595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-408-6200
Provider Business Mailing Address Fax Number:
606-408-6612

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 SCIOTO TRL STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45662-2845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-354-8837
Provider Business Practice Location Address Fax Number:
740-353-7943
Provider Enumeration Date:
10/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  35042736 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000077334 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0429227 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0400034 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 793111263 . This is a "TRAVELERS MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 64766132 . This is a "UNISYS KENTUCKY MEDICAID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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