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General NPI Number Information
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NPI Number | 1891779443
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Entity Type | Individual
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Provider Name | HENDRICK JACKSON ARNOLD III MD
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Gender | Male
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 160 W FILLMORE ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6155
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Country | US
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Telephone | 719-635-1190
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Fax | 719-635-7660
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Provider Business Mailing Address
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Address Line | 4175 STEPNEY CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4834
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Country | US
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Telephone | 719-576-2613
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Fax | 719-579-9398
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 17822
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License Number State | CO
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