Healthcare Provider Details

I. General information

NPI: 1013446764
Provider Name (Legal Business Name): JIMMY WOODROW ARNETT M.ED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 BROADWAY ST
PAINTSVILLE KY
41240
US

IV. Provider business mailing address

1032 BROADWAY ST
PAINTSVILLE KY
41240-1410
US

V. Phone/Fax

Practice location:
  • Phone: 606-789-8531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: