Provider Demographics
NPI:1467430355
Name:ARNOLD, PAUL NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:NORMAN
Last Name:ARNOLD
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 1:777 TANGLEFOOT LN
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1650
Mailing Address - Country:US
Mailing Address - Phone:563-323-2020
Mailing Address - Fax:563-328-5694
Practice Address - Street 1:777 TANGLEFOOT LN
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1650
Practice Address - Country:US
Practice Address - Phone:563-323-2020
Practice Address - Fax:563-328-5694
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4E53207W00000X
IA23146207W00000X
IL036064392207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202073029Medicaid
P00450778OtherPALMETTO GBA - RAILROAD MEDICARE
P00450778OtherPALMETTO GBA - RAILROAD MEDICARE
MO202073029Medicaid
AR0352090001Medicare NSC
MO0352090001Medicare NSC