1821130709 NPI number — DR. ALLEN KEMP ARNOLD III D.C.

Table of content: DR. ALLEN KEMP ARNOLD III D.C. (NPI 1821130709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821130709 NPI number — DR. ALLEN KEMP ARNOLD III D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARNOLD
Provider First Name:
ALLEN
Provider Middle Name:
KEMP
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARNOLD
Provider Other First Name:
TRIPP
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1821130709
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:
5403 AMITY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POWDER SPRINGS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30127-4952
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-439-6807
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5015 FLOYD RD SW
Provider Second Line Business Practice Location Address:
SUITE 720
Provider Business Practice Location Address City Name:
MABLETON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30126-1673
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-941-1454
Provider Business Practice Location Address Fax Number:
770-819-8004
Provider Enumeration Date:
02/13/2007

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: 111N00000X , with the licence number:  CHIR004668 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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