Provider Demographics
NPI:1952483463
Name:ROLLINS, ARLEN JEFFERY (DO)
Entity Type:Individual
Prefix:DR
First Name:ARLEN
Middle Name:JEFFERY
Last Name:ROLLINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25866 FAIRMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-2214
Mailing Address - Country:US
Mailing Address - Phone:216-292-6263
Mailing Address - Fax:216-292-6263
Practice Address - Street 1:50 BLAINE AVE
Practice Address - Street 2:SUITE 2300, BEDFORD MEDICAL CENTER
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146
Practice Address - Country:US
Practice Address - Phone:440-232-0061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-002264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine