Provider Demographics
NPI:1588710461
Name:MARVIN, ARTHUR JACKSON JR
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:JACKSON
Last Name:MARVIN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W 123RD AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3354
Mailing Address - Country:US
Mailing Address - Phone:907-344-2670
Mailing Address - Fax:
Practice Address - Street 1:2735 E TUDOR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1135
Practice Address - Country:US
Practice Address - Phone:907-562-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health