Provider Demographics
NPI:1437681442
Name:ARNOLD, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:IN
Mailing Address - Zip Code:46721-1179
Mailing Address - Country:US
Mailing Address - Phone:419-633-3961
Mailing Address - Fax:419-633-3981
Practice Address - Street 1:1900 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1304
Practice Address - Country:US
Practice Address - Phone:317-296-7300
Practice Address - Fax:317-296-7329
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier