Provider Demographics
NPI:1538796644
Name:ARTERBURN, MARA RUSHE PIECHOWSKI (DO)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:RUSHE PIECHOWSKI
Last Name:ARTERBURN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 COPLEY CT
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40071-8196
Mailing Address - Country:US
Mailing Address - Phone:859-537-7069
Mailing Address - Fax:
Practice Address - Street 1:2195 HARRODSBURG RD STE 125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3543
Practice Address - Country:US
Practice Address - Phone:859-323-6371
Practice Address - Fax:859-257-3585
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP695207Q00000X
390200000X
KY05663207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program