Basic Information
| Provider Information | |||||||||
| NPI: | 1073651311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARNOLD | ||||||||
| FirstName: | HUGH | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8 | ||||||||
| Address2: | 307 CHISUM STREET | ||||||||
| City: | SICILY ISLAND | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713680008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183895727 | ||||||||
| FaxNumber: | 3183894028 | ||||||||
| Practice Location | |||||||||
| Address1: | 307 CHISUM STREET | ||||||||
| Address2: | |||||||||
| City: | SICILY ISLAND | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713680008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183895727 | ||||||||
| FaxNumber: | 3183894028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN070789 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | APO3775 | LA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 1560171 | 05 | LA | MEDICAID | 437505741B | 01 | LA | BLUE CROSS LA | OTHER |