Provider Demographics
NPI:1992936876
Name:ARNOLD, GRAYCE WINTERS (DO)
Entity type:Individual
Prefix:DR
First Name:GRAYCE
Middle Name:WINTERS
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LEAH
Other - Middle Name:GRAYCE
Other - Last Name:WINTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3106 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4112
Mailing Address - Country:US
Mailing Address - Phone:205-871-7007
Mailing Address - Fax:
Practice Address - Street 1:3106 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4112
Practice Address - Country:US
Practice Address - Phone:205-871-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015817207R00000X
GA69534207R00000X
ALDO.1489207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine