1932463510 NPI number — MEAGAN ASHLEY ARTHUR NP

Table of content: MEAGAN ASHLEY ARTHUR NP (NPI 1932463510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932463510 NPI number — MEAGAN ASHLEY ARTHUR NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARTHUR
Provider First Name:
MEAGAN
Provider Middle Name:
ASHLEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KING
Provider Other First Name:
MEAGAN
Provider Other Middle Name:
ASHLEY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932463510
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2955 MARKET ST
Provider Second Line Business Mailing Address:
SUITE C4
Provider Business Mailing Address City Name:
CHRISTIANSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24073-6575
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-381-0344
Provider Business Mailing Address Fax Number:
540-381-1462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2955 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE C4
Provider Business Practice Location Address City Name:
CHRISTIANSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24073-6575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-381-0344
Provider Business Practice Location Address Fax Number:
540-381-1462
Provider Enumeration Date:
06/28/2012

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: 363L00000X , with the licence number:  0024170152 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1932463510 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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