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NPI Code Detail

MEDICARE: DR. DUSTIN LECLERE ARNOLD D.O.

MEDICARE: DR. DUSTIN LECLERE ARNOLD D.O.
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
1208M00000XHospitalist Physician03111IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00339683OTHERIARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
225730OTHERIABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1689617144
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUSTIN LECLERE ARNOLD D.O.
Provider Business Mailing Address
First Line : 1026 A AVE NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-5036
Country : US
Telephone Number : 319-368-5970
Fax Number : 319-368-5973
Provider Business Practice Location Address
First Line : 1026 A AVE NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-5036
Country : US
Telephone Number : 319-368-5970
Fax Number : 319-368-5973
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 07/14/2008

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