Provider Demographics
NPI:1811202294
Name:ARNDT, ETHAN J (OD)
Entity Type:Individual
Prefix:
First Name:ETHAN
Middle Name:J
Last Name:ARNDT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:205 E DIMOND BLVD STE 272
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1909
Mailing Address - Country:US
Mailing Address - Phone:907-538-2800
Mailing Address - Fax:907-268-4287
Practice Address - Street 1:1501 E PARKS HWY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8283
Practice Address - Country:US
Practice Address - Phone:907-357-1455
Practice Address - Fax:907-357-1456
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AKOPTT311152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist