Basic Information
Provider Information
NPI: 1730342213
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARNOLD
FirstName: JAMES
MiddleName: TOBY
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 234 MEDICAL CIR
Address2:  
City: MOREHEAD
State: KY
PostalCode: 403511194
CountryCode: US
TelephoneNumber: 6067846641
FaxNumber: 6067802373
Practice Location
Address1: 234 MEDICAL CIR
Address2:  
City: MOREHEAD
State: KY
PostalCode: 403511194
CountryCode: US
TelephoneNumber: 6067846641
FaxNumber: 6067802373
Other Information
ProviderEnumerationDate: 07/06/2008
LastUpdateDate: 12/07/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X03301KYN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207R00000X03301KYY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
710013008005KY MEDICAID


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