Provider Demographics
NPI:1215066006
Name:ROBERT J. ARNOLD
Entity type:Organization
Organization Name:ROBERT J. ARNOLD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-241-5810
Mailing Address - Street 1:115 E MARLIN ST
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-4300
Mailing Address - Country:US
Mailing Address - Phone:620-241-5810
Mailing Address - Fax:620-241-5810
Practice Address - Street 1:115 E MARLIN ST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-4300
Practice Address - Country:US
Practice Address - Phone:620-241-5810
Practice Address - Fax:620-241-5810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1015-2152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100090770AMedicaid
KS0602890001OtherCIGNA
KS005270OtherBCBS
KS005270OtherBCBS
KS100090770AMedicaid