Healthcare Provider Details

I. General information

NPI: 1164416640
Provider Name (Legal Business Name): SAMUEL H ARNOLD III D O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 S BRADLEY ST
WARREN AR
71671-3459
US

IV. Provider business mailing address

1316 S HIGHWAY 7
SPARKMAN AR
71763-8674
US

V. Phone/Fax

Practice location:
  • Phone: 870-226-3731
  • Fax:
Mailing address:
  • Phone: 870-807-4255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberE-2458
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: