Provider Demographics
NPI:1275530065
Name:ARZOLA, FERNANDO ASDRUBAL (MD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:ASDRUBAL
Last Name:ARZOLA
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:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:420 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957-1024
Practice Address - Country:US
Practice Address - Phone:573-223-4233
Practice Address - Fax:573-223-2136
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07084R207RC0000X
MO2016032741207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1360503Medicaid
LA060048866OtherRR MEDICARE
LAB89747Medicare UPIN
LA060048866OtherRR MEDICARE