1376698449 NPI number — DR. JAMES FRED ARNOLD III DMD FAACP

Table of content: DR. JAMES FRED ARNOLD III DMD FAACP (NPI 1376698449)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376698449 NPI number — DR. JAMES FRED ARNOLD III DMD FAACP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARNOLD
Provider First Name:
JAMES
Provider Middle Name:
FRED
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
DMD FAACP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376698449
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
699 PERIMETER DRIVE
Provider Second Line Business Mailing Address:
STE #200
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-269-1000
Provider Business Mailing Address Fax Number:
859-266-1445

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
699 PERIMETER DRIVE
Provider Second Line Business Practice Location Address:
STE #200
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-269-1000
Provider Business Practice Location Address Fax Number:
859-266-1445
Provider Enumeration Date:
01/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  703 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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