Basic Information
| Provider Information | |||||||||
| NPI: | 1114934056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARNOLD | ||||||||
| FirstName: | SUSANNE | ||||||||
| MiddleName: | MARKESBERY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2333 ALUMNI PARK PLZ | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405174012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592185677 | ||||||||
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| Practice Location | |||||||||
| Address1: | 740 S LIMESTONE | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593235116 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 06/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 31171 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RX0202X | 31171 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0000X | 31171 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0003X | 31171 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 64311715 | 05 | KY | MEDICAID |