Provider Demographics
NPI:1861462178
Name:ARNOLD, TIMOTHY LYON (DO)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:LYON
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 1:5000 HIGHWAY 39 N
Mailing Address - Street 2:ALLIANCE HEALTH CENTER INC
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301
Mailing Address - Country:US
Mailing Address - Phone:601-483-6211
Mailing Address - Fax:601-482-3623
Practice Address - Street 1:5000 HIGHWAY 39 N
Practice Address - Street 2:ALLIANCE HEALTH CENTER INC
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301
Practice Address - Country:US
Practice Address - Phone:601-483-6211
Practice Address - Fax:601-482-3623
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB070278002084P0800X
MS198432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06481203Medicaid
NJ8861102Medicaid
NJ067484AOYMedicare ID - Type Unspecified
NJ8861102Medicaid
302I260140Medicare Oscar/Certification