Basic Information
Provider Information
NPI: 1043758238
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARNOLD
FirstName: SAMANTHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 333 BORTHWICK AVE
Address2:  
City: PORTSMOUTH
State: NH
PostalCode: 038017128
CountryCode: US
TelephoneNumber: 6036861717
FaxNumber:  
Practice Location
Address1: 272 HOSPITAL RD
Address2:  
City: CHILLICOTHE
State: OH
PostalCode: 456019031
CountryCode: US
TelephoneNumber: 7407797500
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/07/2017
LastUpdateDate: 01/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X20244NHY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


Home