=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437681442
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN M ARNOLD CP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2017
-----------------------------------------------------
Last Update Date | 04/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 408 E WATERFORD ST
-----------------------------------------------------
City | WAKARUSA
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46573-9552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 574-862-0007
-----------------------------------------------------
Fax | 574-862-0020
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 408 E WATERFORD ST
-----------------------------------------------------
City | WAKARUSA
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46573-9552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-635-1075
-----------------------------------------------------
Fax | 574-862-0020
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------