Provider Demographics
NPI:1699754606
Name:NOTHNAGEL, ARNOLD F (DO)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:F
Last Name:NOTHNAGEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4690 MUNSON ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3636
Mailing Address - Country:US
Mailing Address - Phone:330-966-9800
Mailing Address - Fax:330-966-9803
Practice Address - Street 1:4690 MUNSON ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3636
Practice Address - Country:US
Practice Address - Phone:330-966-9800
Practice Address - Fax:330-966-9803
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-003648207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0692522Medicaid
OHP00290869OtherRAILROAD MEDICARE
OHF04245Medicare UPIN
OH0692522Medicaid