Provider Demographics
NPI:1164416640
Name:ARNOLD, SAMUEL H III (D O)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:H
Last Name:ARNOLD
Suffix:III
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 S HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:SPARKMAN
Mailing Address - State:AR
Mailing Address - Zip Code:71763-8674
Mailing Address - Country:US
Mailing Address - Phone:870-807-4255
Mailing Address - Fax:
Practice Address - Street 1:404 S BRADLEY ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:AR
Practice Address - Zip Code:71671-3459
Practice Address - Country:US
Practice Address - Phone:870-226-3731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-2458208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1164416640OtherQUALCHOICE
5181488OtherAETNA
AR141442003Medicaid
207122OtherHEALTHLINK
0000129360506OtherUNITED HEALTH CARE
020053473OtherRAILROAD MEDICARE