Provider Demographics
NPI:1538900394
Name:YAMPOLSKY, ARNOLD (PA-S)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:YAMPOLSKY
Suffix:
Gender:M
Credentials:PA-S
Other - Prefix:
Other - First Name:RONNY
Other - Middle Name:
Other - Last Name:YAMPOLSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-S
Mailing Address - Street 1:3503 ROCKCLIFF CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35210-3030
Mailing Address - Country:US
Mailing Address - Phone:205-516-9497
Mailing Address - Fax:
Practice Address - Street 1:3503 ROCKCLIFF CIR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35210-3030
Practice Address - Country:US
Practice Address - Phone:205-516-9497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8352522390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program