Provider Demographics
NPI:1528090339
Name:ARSENAULT, WILLIAM R (PA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:ARSENAULT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:199 BETHESDA CHURCH RD W
Mailing Address - Street 2:WEST
Mailing Address - City:HOLTWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:17532-9746
Mailing Address - Country:US
Mailing Address - Phone:717-875-8377
Mailing Address - Fax:
Practice Address - Street 1:199 BETHESDA CHURCH RD W
Practice Address - Street 2:WEST
Practice Address - City:HOLTWOOD
Practice Address - State:PA
Practice Address - Zip Code:17532-9746
Practice Address - Country:US
Practice Address - Phone:717-875-8377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA002822363AM0700X
MDC03537363AM0700X
PAMA055032363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S44016Medicare UPIN