Organization
EKG PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAVIER ARCE (PHYSICIAN AND OWNER)
(270) 765-5921
Entity
Organization
Contact information
Practice address
913 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2503
(270) 765-5921
Mailing address
3077 SOLUTIONS CTR, CHICAGO, IL 60677-3000
(270) 765-5921
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000059614
ANTHEM BCBS
—
01
—
1083705
PASSPORT
—
01
—
2435631000
PASSPORT ADVANTAGE
—
05
—
65914590
—
KY
01
—
CF7923
RAILROAD MEDICARE
—
Enumeration date
05/24/2007
Last updated
08/22/2020
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