Provider Demographics
NPI:1194710293
Name:ARNOLD, LINDA S (MD)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:260 W CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-5430
Mailing Address - Country:US
Mailing Address - Phone:478-986-4743
Mailing Address - Fax:478-986-3921
Practice Address - Street 1:260 W CLINTON ST
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:GA
Practice Address - Zip Code:31032-5430
Practice Address - Country:US
Practice Address - Phone:478-986-4743
Practice Address - Fax:478-986-3921
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA040299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00664023CMedicaid
GA08BDMXXMedicare PIN
GA080127110Medicare PIN
GAF84938Medicare UPIN