Healthcare Provider Details

I. General information

NPI: 1073351854
Provider Name (Legal Business Name): JOSHUA C ARNETT OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S CAROL MALONE BLVD
GRAYSON KY
41143-1357
US

IV. Provider business mailing address

313 S CAROL MALONE BLVD
GRAYSON KY
41143-1357
US

V. Phone/Fax

Practice location:
  • Phone: 606-474-7833
  • Fax: 606-474-3563
Mailing address:
  • Phone: 606-474-7833
  • Fax: 606-474-3563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2415DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: