Provider Demographics
NPI:1548274509
Name:ARN, CLIFFORD C (MD)
Entity type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:C
Last Name:ARN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6856 103RD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-6877
Mailing Address - Country:US
Mailing Address - Phone:904-777-0616
Mailing Address - Fax:904-777-0688
Practice Address - Street 1:6856 103RD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-6877
Practice Address - Country:US
Practice Address - Phone:904-777-0616
Practice Address - Fax:904-777-0688
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0055583207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08865UMedicare PIN
FLB67205Medicare UPIN