Provider Demographics
NPI:1881876977
Name:ARNOLD, ROBERT SIDNEY (MD, MS, BS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SIDNEY
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:MD, MS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:206 CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3313
Mailing Address - Country:US
Mailing Address - Phone:303-257-4534
Mailing Address - Fax:
Practice Address - Street 1:37 WIDEFIELD BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80911-2126
Practice Address - Country:US
Practice Address - Phone:719-282-6100
Practice Address - Fax:719-282-6106
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01318195Medicaid
C67799Medicare UPIN
CO01318195Medicaid