Provider Demographics
NPI:1316992662
Name:ARCY, EDWARD THOMAS (DO)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:THOMAS
Last Name:ARCY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 HOSPITAL DR STE 4500
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9693
Mailing Address - Country:US
Mailing Address - Phone:614-788-0588
Mailing Address - Fax:614-788-0587
Practice Address - Street 1:7450 HOSPITAL DR STE 4500
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9693
Practice Address - Country:US
Practice Address - Phone:614-788-0588
Practice Address - Fax:614-788-0587
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003545A208D00000X
OH34.003545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0540534Medicaid
D89786Medicare UPIN
OH0540534Medicaid