Healthcare Provider Details

I. General information

NPI: 1235058124
Provider Name (Legal Business Name): CHAZ ARNOLD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 EASTERN BYP
RICHMOND KY
40475-2751
US

IV. Provider business mailing address

793 EASTERN BYP STE 110
RICHMOND KY
40475-2425
US

V. Phone/Fax

Practice location:
  • Phone: 859-625-3131
  • Fax:
Mailing address:
  • Phone: 270-315-4834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAZ M ARNOLD
Title or Position: OWNER
Credential: DO
Phone: 859-624-2020