Provider Demographics
NPI:1114122058
Name:SCOTT B. ARNETT M.D., PSC
Entity Type:Organization
Organization Name:SCOTT B. ARNETT M.D., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:BIRCH
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-789-5979
Mailing Address - Street 1:313 WEST ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-1054
Mailing Address - Country:US
Mailing Address - Phone:606-789-5979
Mailing Address - Fax:606-788-0387
Practice Address - Street 1:313 WEST ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PAINTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41240-1054
Practice Address - Country:US
Practice Address - Phone:606-789-5979
Practice Address - Fax:606-788-0387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35140207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64018088Medicaid
KY64018088Medicaid
KY7135Medicare ID - Type Unspecified