Provider Demographics
NPI:1033162375
Name:ARNOLD, WALTER DAVIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:DAVIS
Last Name:ARNOLD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:119 BOONE RIDGE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-4998
Mailing Address - Country:US
Mailing Address - Phone:423-282-1480
Mailing Address - Fax:423-928-1353
Practice Address - Street 1:1 MEDICAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-7430
Practice Address - Country:US
Practice Address - Phone:423-282-1480
Practice Address - Fax:423-928-1353
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2024-03-26
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Provider Licenses
StateLicense IDTaxonomies
TN40585208M00000X
IL036-096921207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-096921Medicaid
IL036-096921Medicaid
ILG63609Medicare UPIN