MEDICARE: JUDITH ARNOLD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	30529	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578592572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH ARNOLD MD

Provider Business Mailing Address
First Line	:	5300 MEMORIAL DR
Second Line	:
City	:	TWO RIVERS
State	:	WI
Zip	:	54241-3923
Country	:	US
Telephone Number	:	920-793-7421
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 MEMORIAL DR
Second Line	:
City	:	TWO RIVERS
State	:	WI
Zip	:	54241-3923
Country	:	US
Telephone Number	:	920-793-7421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	11/18/2021

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