Provider Demographics
NPI:1265454276
Name:ARNDT, TODD JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:JAMES
Last Name:ARNDT
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:P O BOX 1047
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638-1047
Mailing Address - Country:US
Mailing Address - Phone:208-634-2225
Mailing Address - Fax:208-634-7212
Practice Address - Street 1:211 FOREST STREET
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83686
Practice Address - Country:US
Practice Address - Phone:208-634-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-8342207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010158666OtherBS PLMC
ID000010160244OtherBS DMC
IDB5782OtherBC DMC
ID76847OtherBC PLMC
IDB5782OtherBC DMC
H87562Medicare UPIN