Provider Demographics
NPI:1275583791
Name:ARNSON, DOUGLAS S (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:S
Last Name:ARNSON
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 1:17350 COLDWATER TRL
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-1413
Mailing Address - Country:US
Mailing Address - Phone:216-832-6832
Mailing Address - Fax:
Practice Address - Street 1:17350 COLDWATER TRL
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-1413
Practice Address - Country:US
Practice Address - Phone:216-832-6832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0562942085R0202X
KY443892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0845732Medicaid
OH877239Medicare ID - Type Unspecified
OH0845732Medicaid
OHAR4243841Medicare PIN