Provider Demographics
NPI:1497867022
Name:WALL, ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:WALL
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 1:231 ALBERT SABIN WAY
Mailing Address - Street 2:ML0769
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0001
Mailing Address - Country:US
Mailing Address - Phone:513-281-4400
Mailing Address - Fax:513-281-4545
Practice Address - Street 1:231 ALBERT SABIN WAY
Practice Address - Street 2:ML0769
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0001
Practice Address - Country:US
Practice Address - Phone:513-281-4400
Practice Address - Fax:513-281-4545
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-074388207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2074017Medicaid
OHWA0854386Medicare ID - Type Unspecified
OH2074017Medicaid