Provider Demographics
NPI:1194752899
Name:ARNOW, JONATHAN R (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:R
Last Name:ARNOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 CAROL LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4411
Mailing Address - Country:US
Mailing Address - Phone:508-486-5605
Mailing Address - Fax:508-486-5506
Practice Address - Street 1:157 UNION ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1228
Practice Address - Country:US
Practice Address - Phone:508-486-5605
Practice Address - Fax:508-486-5506
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0594752085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3035026Medicaid
MAJ07397Medicare ID - Type Unspecified
B98182Medicare UPIN