Provider Demographics
NPI:1407075153
Name:ARNOSCHT, OTTO JOHANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:OTTO
Middle Name:JOHANN
Last Name:ARNOSCHT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36093-3828
Mailing Address - Country:US
Mailing Address - Phone:334-399-9115
Mailing Address - Fax:866-614-8582
Practice Address - Street 1:45 CEDAR RIDGE DR
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36093-3828
Practice Address - Country:US
Practice Address - Phone:334-399-9115
Practice Address - Fax:866-614-8582
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0425103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51516955ARNOtherBLUE CROSS BLUE SHIELD OF
AL51516955ARNOtherBLUE CROSS BLUE SHIELD OF