Provider Demographics
NPI:1912044579
Name:MOLLEN, ARTHUR J (DO)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:J
Last Name:MOLLEN
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 1:16100 N 71ST ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2209
Mailing Address - Country:US
Mailing Address - Phone:480-656-0016
Mailing Address - Fax:480-634-1723
Practice Address - Street 1:16100 N 71ST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2209
Practice Address - Country:US
Practice Address - Phone:480-656-0016
Practice Address - Fax:480-634-1723
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1097207Q00000X
PA0S002787L207Q00000X
CA20A 3308207Q00000X
CA20A3308207Q00000X
PAOS002787L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ264028Medicaid
AZ1097OtherSTATE MEDICAL LICENSE
AZ1097OtherSTATE MEDICAL LICENSE
AZ264028Medicaid
AZD47295Medicare UPIN
AZ104998Medicare ID - Type UnspecifiedPROVIDER ID#