Provider Demographics
NPI:1609966803
Name:RICHARD ARNOLD MD PSC
Entity Type:Organization
Organization Name:RICHARD ARNOLD MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WOOD
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-234-4833
Mailing Address - Street 1:302 E PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-1684
Mailing Address - Country:US
Mailing Address - Phone:859-234-4833
Mailing Address - Fax:859-234-0838
Practice Address - Street 1:302 E PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-1684
Practice Address - Country:US
Practice Address - Phone:859-234-4833
Practice Address - Fax:859-234-0838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY208D00000X261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64184088Medicaid
KY8924Medicare PIN
KYC70460Medicare UPIN