Provider Demographics
NPI:1982695011
Name:ARNOLD, THOMAS BENJAMIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BENJAMIN
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2331
Mailing Address - Country:US
Mailing Address - Phone:330-956-4857
Mailing Address - Fax:
Practice Address - Street 1:4503 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2331
Practice Address - Country:US
Practice Address - Phone:330-956-4857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003407213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHV05729Medicare UPIN
OHAR4163851Medicare ID - Type Unspecified