Provider Demographics
NPI:1821096843
Name:ARNOLD, DOUGLAS E (PT ATC)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:E
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:PT ATC
Other - Prefix:
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Mailing Address - Street 1:PO BOX 14547
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73113-0547
Mailing Address - Country:US
Mailing Address - Phone:405-810-2902
Mailing Address - Fax:405-810-2905
Practice Address - Street 1:6801 N CLASSEN BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-7205
Practice Address - Country:US
Practice Address - Phone:405-810-2902
Practice Address - Fax:405-810-2905
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200272660AMedicaid
OK370203Medicare Oscar/Certification
OK200272660AMedicaid