Provider Demographics
NPI:1689617144
Name:ARNOLD, DUSTIN LECLERE (DO)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:LECLERE
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 A AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5036
Mailing Address - Country:US
Mailing Address - Phone:319-368-5970
Mailing Address - Fax:319-368-5973
Practice Address - Street 1:1026 A AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5036
Practice Address - Country:US
Practice Address - Phone:319-368-5970
Practice Address - Fax:319-368-5973
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03111208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4183301Medicaid
IA25730OtherBLUE CROSS BLUE SHIELD
IAP00339683OtherRR MEDICARE
IAI18233Medicare PIN
IA4183301Medicaid