Provider Demographics
NPI:1407352693
Name:ARNOLD, TRAVIS THOMPSON (DO)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:THOMPSON
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 FOX HILL RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2360
Mailing Address - Country:US
Mailing Address - Phone:757-850-1311
Mailing Address - Fax:757-850-7315
Practice Address - Street 1:191 FOX HILL RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2360
Practice Address - Country:US
Practice Address - Phone:757-850-1311
Practice Address - Fax:757-850-7315
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102206969207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program