Provider Demographics
NPI:1811087786
Name:ARNOLD, PAULSEN COLEMAN (OD)
Entity type:Individual
Prefix:DR
First Name:PAULSEN
Middle Name:COLEMAN
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 N PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2947
Mailing Address - Country:US
Mailing Address - Phone:229-244-3000
Mailing Address - Fax:229-244-0399
Practice Address - Street 1:232 GREEN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2000
Practice Address - Country:US
Practice Address - Phone:252-792-6611
Practice Address - Fax:252-799-0797
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1696152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890926FMedicaid
NC0926FOtherBCBSNC PIN
NC0926FOtherBCBSNC PIN
NCU76232Medicare UPIN