Provider Demographics
NPI:1659591592
Name:ARNOLD, PHILIP KERNEY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:KERNEY
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 COUNTY ROAD 579
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37329-5106
Mailing Address - Country:US
Mailing Address - Phone:423-745-7023
Mailing Address - Fax:
Practice Address - Street 1:2 S HILL ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-4273
Practice Address - Country:US
Practice Address - Phone:423-745-1101
Practice Address - Fax:423-745-9652
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS22451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0139374OtherBCBS OF TN
851021OtherUNITED CONCORDIA