Provider Demographics
NPI:1750440574
Name:ARNOLD, MAURICE FRANKLIN (MD)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:FRANKLIN
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4687
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31208-4687
Mailing Address - Country:US
Mailing Address - Phone:478-745-0711
Mailing Address - Fax:
Practice Address - Street 1:380 HOSPITAL DR
Practice Address - Street 2:SUITE 370
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-8001
Practice Address - Country:US
Practice Address - Phone:478-745-0711
Practice Address - Fax:478-745-9639
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022713208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52235403 001OtherBCBS PROVIDER #
GA303572OtherWELL CARE PROVIDER #
GAD44741Medicare UPIN
GA303572OtherWELL CARE PROVIDER #