Provider Demographics
NPI:1598965493
Name:ARNOLD, ROBERT
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5346 W GREEN CT
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-7845
Mailing Address - Country:US
Mailing Address - Phone:760-725-8882
Mailing Address - Fax:760-725-1267
Practice Address - Street 1:NAVAL HOSPITAL CAMP PENDLETON
Practice Address - Street 2:BLDG H-100 SANTA MARGARITA ROAD
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-9151
Practice Address - Country:US
Practice Address - Phone:760-725-8882
Practice Address - Fax:760-725-1267
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8461208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery