Healthcare Provider Details

I. General information

NPI: 1013276229
Provider Name (Legal Business Name): AMANDA ARNOLD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2012
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 SPRINGFIELD PIKE
CINCINNATI OH
45246-4112
US

IV. Provider business mailing address

2139 AUBURN AVE STE 2170
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-782-2448
  • Fax: 513-782-2451
Mailing address:
  • Phone: 513-585-2288
  • Fax: 513-585-4892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57021204
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number57.248259
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: