Provider Demographics
NPI:1497917876
Name:ARNOLD, SCOTT DAVID
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DAVID
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 1:320 DEWEY AVE STE A
Mailing Address - Street 2:NAVAL SPECIAL WARFARE PREPARATORY SCHOOL BLDG 322
Mailing Address - City:GREAT LAKES
Mailing Address - State:IL
Mailing Address - Zip Code:60088-2911
Mailing Address - Country:US
Mailing Address - Phone:847-688-6201
Mailing Address - Fax:847-688-6140
Practice Address - Street 1:320 DEWEY AVE STE A
Practice Address - Street 2:NAVAL SPECIAL WARFARE PREPARATORY SCHOOL BLDG 322
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088-2911
Practice Address - Country:US
Practice Address - Phone:847-688-6201
Practice Address - Fax:847-688-6140
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman