Healthcare Provider Details

I. General information

NPI: 1649486622
Provider Name (Legal Business Name): RICHARD ANTHONY ARNELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 VALLEY VIEW DR STE 102
MOLINE IL
61265-6150
US

IV. Provider business mailing address

615 VALLEY VIEW DR STE 102
MOLINE IL
61265-6150
US

V. Phone/Fax

Practice location:
  • Phone: 309-762-7227
  • Fax:
Mailing address:
  • Phone: 309-762-7227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036-041661
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number17160
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number036-041661
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number17160
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: