Provider Demographics
NPI:1629062260
Name:ARNOLD, COLEMAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:COLEMAN
Middle Name:L
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 1:979 E 3RD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-629-1491
Mailing Address - Fax:423-629-1493
Practice Address - Street 1:2108 E 3RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2600
Practice Address - Country:US
Practice Address - Phone:423-267-0466
Practice Address - Fax:423-493-2371
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD7767174400000X
TN7767208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
020039036OtherRR MEDICARE
TN3076748OtherBCBS OF TN
2585653 001OtherCIGNA
1740002OtherUHC
TN3163573Medicaid
TN3076748OtherBCBS OF TN
TN3163573Medicaid
3163570Medicare ID - Type Unspecified
TN3076748OtherBCBS OF TN
3163579Medicare ID - Type Unspecified