Provider Demographics
NPI:1093144610
Name:ARLINGTON PHYSICIAN SERVICES PA
Entity type:Organization
Organization Name:ARLINGTON PHYSICIAN SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTO
Authorized Official - Middle Name:
Authorized Official - Last Name:KOULISIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-693-1000
Mailing Address - Street 1:265 BROOKVIEW CENTRE WAY
Mailing Address - Street 2:STE 400
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4049
Mailing Address - Country:US
Mailing Address - Phone:865-693-1000
Mailing Address - Fax:
Practice Address - Street 1:11800 ASTORIA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6041
Practice Address - Country:US
Practice Address - Phone:919-655-1325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty