Provider Demographics
NPI:1225085962
Name:PENIX, ARNOLD R (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:R
Last Name:PENIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:STE C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3359
Mailing Address - Country:US
Mailing Address - Phone:513-985-3700
Mailing Address - Fax:513-985-3706
Practice Address - Street 1:8311 MONTGOMERY ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2227
Practice Address - Country:US
Practice Address - Phone:513-985-3700
Practice Address - Fax:513-985-3706
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-8478207X00000X
WV20394207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH310917085044Medicaid
1225085962OtherNPI
WV1804319000Medicaid
OH0836304Medicaid
OH000000181646Medicaid
1225085962OtherNPI
OH000000181646Medicaid