Provider Demographics
NPI: | 1164490843 |
---|---|
Name: | ARNETT CLINIC, LLC |
Entity Type: | Organization |
Organization Name: | ARNETT CLINIC, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DANIEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NEUFELDER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 765-448-8000 |
Mailing Address - Street 1: | 1200 W WHITE RIVER BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | MUNCIE |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 47303-4988 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 877-668-5621 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5165 MCCARTY LN |
Practice Address - Street 2: | |
Practice Address - City: | LAFAYETTE |
Practice Address - State: | IN |
Practice Address - Zip Code: | 47905-8764 |
Practice Address - Country: | US |
Practice Address - Phone: | 765-448-8000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-03-09 |
Last Update Date: | 2021-06-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IN | 207L00000X, 207N00000X, 207P00000X, 207Q00000X, 207R00000X, 207V00000X, 207W00000X, 207X00000X, 207Y00000X, 208000000X, 2085R0202X, 2085R0204X, 208600000X, 208M00000X, 208VP0014X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 208VP0014X | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IN | 100332560 | Medicaid | |
IN | 200141420 | Medicaid | |
IN | 815490 | Medicare PIN | |
IN | 815630 | Medicare PIN | |
IN | 185820 | Medicare PIN | |
IN | 069330 | Medicare PIN | |
IN | 142080 | Medicare PIN | |
IN | 142090 | Medicare PIN | |
IN | 199190 | Medicare PIN | |
IN | 815500 | Medicare PIN | |
IN | 815520 | Medicare PIN | |
IN | 921480 | Medicare PIN | |
IN | 815450 | Medicare PIN | |
IN | 815460 | Medicare PIN | |
IN | 100332560 | Medicaid | |
IN | 185510 | Medicare PIN | |
IN | 199200 | Medicare PIN | |
IN | 815510 | Medicare PIN | |
IN | 224390 | Medicare PIN | |
IN | 083820 | Medicare PIN |