Provider Demographics
NPI:1043444532
Name:ARNOLD, THOMAS GREGORY (IDMT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:GREGORY
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 112 BOX 153
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09717-0002
Mailing Address - Country:US
Mailing Address - Phone:003165-174-5268
Mailing Address - Fax:
Practice Address - Street 1:PSC 112 BOX 153
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09717-0002
Practice Address - Country:US
Practice Address - Phone:003165-174-5268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians