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Individual

MICHAEL J JARVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
815 E PARRISH AVE, SUITE 330, OWENSBORO, KY 42303-3222
(270) 688-0900
(270) 685-0050
Mailing address
815 E PARRISH AVE, SUITE 330, OWENSBORO, KY 42303-3222
(270) 688-0900
(270) 685-0050

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
15139
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000041803
ANTHEM BCBS
01
010435700
BLACK LUNG
01
060044957
RAILROAD MEDICARE
05
100033110A
IN
01
1524493
UMWA
05
64151392
KY
Enumeration date
07/20/2005
Last updated
12/07/2010
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