Healthcare Provider Details

I. General information

NPI: 1174367296
Provider Name (Legal Business Name): MATTHEW LOYD ARNOLD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 W 6TH AVE
STILLWATER OK
74074-4399
US

IV. Provider business mailing address

4599 N WASHINGTON ST APT 21J
STILLWATER OK
74075-1338
US

V. Phone/Fax

Practice location:
  • Phone: 405-784-5842
  • Fax:
Mailing address:
  • Phone: 951-442-0163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0751R
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: